Winnie Loves Us

Winnie loves Minneapolis

2011-11-07T20:28:00.003-06:00

Oh blog. Has it really been almost a year since last we wrote?

Well, I suppose not much has changed since then... except that I moved back home, got a great job, and we moved into an awesome little house in south Minneapolis.

Here's to our triumphant return to blogging!

Winnie loves Minneapolis!

Winnie update, thoughts on Tucson, and NAVC

2011-01-14T13:39:00.007-06:00

I'm in the Tucson airport waiting for my flight to leave, and since the airport kindly provides free Wi-Fi, I thought I'd post a little update...
Winnie Bear is pretty much back to her old self. None of the tests we ran found any cause for her pneumonia, but after her lung biopsy she turned around and seemed to get better every day. Her chest x-rays that we took on Monday looked normal, so whatever happened seems to be behind us. The going theory is that the lung biopsy released the evil spirits ;) Whatever works!

Of course the whole country has had its eyes on Tucson for the past week... It's still all a little surreal. I keep seeing the mountains in the background of photos and thinking, "Wow, that place looks just like Tucson." I think everyone is still absorbing the full impact of what happened. I don't live very close to where the shootings occurred, but it's certainly a familiar area. Gabrielle Gifford's office is on my way to work, so I have been watching the number of flowers, signs, candles, and other memorials grow every day. President Obama's speech seemed to resonate well with everyone. I hope we eventually get some insight into what drove Laughner to do what he did and destroy the lives of so many people.

For now, I am leaving sunny Tucson behind for a week in sunny Orlando at the North American Veterinary Conference. This is my first time off from my internship since I went home in August. I've never been to NAVC, but it's supposed to be completely amazing and overwhelming. There are over 20 lectures to choose from every hour for 9 hours a day, plus breakfast lectures before the official lectures start, plus lunch-and-learn lectures, plus dinner lectures after the official lectures end, plus wetlabs and master classes. There are tons of avian and exotics lectures this year, and I'll be attending a master class about avian medicine that should be really valuable. They say you need to set aside a whole day just to peruse the exhibit hall and look at all the fun new gadgets, medicines, books, and supplies available in vet med this year. Should be great! I'll also get to see a handful of classmates, so it will be fun to catch up and see how everyone's been doing since graduation.

Hooray for travel and seeing vet friends!

Good thoughts for Winnie

2010-12-18T07:45:00.004-06:00

Our poor little Pooh Bear has been fighting a strange mystery disease since Thanksgiving. Everything started with urinary tract signs (mostly frequent urination, peeing in the house, etc). She was started on an antibiotic and all those signs cleared up, but a couple of days later she developed a fever. That started us on a wild goose change through her abdomen looking for the cause- did a bladder infection ascend to her kidneys? Did she eat something inappropriate? We sent out a urine culture (negative), checked bloodwork (normal aside from an elevated white blood cell count), and checked for tick-borne diseases (negative, plus she's on monthly tick preventatives). Radiographs revealed an enlarged spleen, so she had an abdominal ultrasound. Aside from a slightly prominent spleen, no other abnormalities were noted. A splenic aspirate was sent out- nothing really significant there either.

Winnie's fever persisted, so the hunt moved from her abdomen to her chest. Thoracic radiographs revealed consolidation of her right cranial lung lobe. Suspecting pneumonia, we started her on some more antibiotics, but her fever didn't really respond... So off to the U of MN teaching hospital she went. Although they agreed it would be strange for a middle-aged otherwise healthy dog to suddenly develop pneumonia, the radiographs and bloodwork were all consistent with pneumonia and didn't revealed any potential underlying causes. We decided to give the antibiotics a little more time to work, and Winnie's fever disappeared for a couple of days. Unfortunately, it came back... so Winnie went back to the U for a transtracheal wash to try and collect some of the organisms causing her pneumonia and culture them out. After a few days of waiting, nothing grew on her cultures. She had another day or two of being fever-free, but then it all started again. Her doctor then performed a fine-needle aspirate of the affected lung lobe, hoping to find the organisms causing her disease, but the samples just showed inflammatory cells. We added one more antibiotic to her regimen as well as an anti-inflammatory to give her some relief from the fever... which worked great until the drug wore off and the fever came right back.

After 2 1/2 weeks of trying different medications, we finally decided that we needed to try something else. Based on Winnie's age and the focal nature of her pneumonia, we suspected that she might have a migrating foreign body (i.e. she inhaled a seed or bit of a plant, which was travelling through her lungs and wreaking havoc). Unfortunately, Winnie was too small for bronchoscopy to be an option to explore the problem lung lobe. We finally bit the bullet and decided to take her for a CT scan and, if everything was still limited to her right cranial lobe, proceed to a lung lobectomy. Her CT scan was Thursday, and (because nothing in her case has gone as expected) the images showed that the lung lobe that had been looking bad was looking better, but now several of the lobes on her left side were looking affected. Sigh. She wasn't doing great under anesthesia, so she was recovered and went home on Thursday night. She returned to the U yesterday for a lung biopsy, in the hopes that getting a piece of tissue would be more likely to grow organisms in culture or show us any other underlying problems with her lung itself. Cytology yesterday unfortunately just came back as "neutrophilic inflammation" with no evidence of organisms... so now we wait for histopathology results to come in.

Winnie has been in the ICU since her biopsy with a chest tube in place. She's doing well, and if everything goes according to plan, she'll be going home in the next day or two. For now, we are onto yet another class of antibiotics to see if whatever's in her lungs responds. Winnie is being a trooper, and even though she hates the hospital and being in a kennel all day, she is tolerating everything pretty well.

So, please keep our little Winnie girl in your thoughts. It is miserable to be so far away from her during this, but her vets in Minnesota have all been fantastic and she's in the best hands. All we want for Christmas is a healthy corgi, and some answers about why she's been so sick!

bad blogger

2010-10-06T18:32:00.003-05:00

Okay... so my pledge to write about something I learned every day didn't exactly work out. I am still learning lots, of course, and I'll do my best to get back to blogging regularly. But for now, I spend most of my (rare) free time either baking or curling up for naps with this kiddo (how can I resist when he makes napping look so amazing?)...

Winnie kills a sick

2010-09-22T23:12:00.001-05:00

Whole Wheat Cinnamon Raisin Bread with Oats and Coconut

2010-09-06T16:08:00.002-05:00

This one used up the rest of the flour in the house. I am sure burning through it! For fine french breads I like to use bread flour, which has about 25% more protein (aka gluten) which makes the bread structure stronger internally and lets it rise high. But, with breads with lots of additions like this I feel like it is kind of pointless and general flour works just as well.

I added egg in this time, and I can't really tell what it does to the bread. I think it gives it fluff by binding things together similarly to what the gluten does, but I can't find any information on this online. Anyone know?

Otherwise, I just let the raisins, yeast, sugar, and coconut soak for a while, then added the flour until it mixed right. But, I forgot to leave any for flouring the counter for kneeding, so I tried using the silicone mat Megan uses for chocolate and it worked great. A good thing to know for working with wet dough that you still want to work with.

Another nice tip I found for softer/chewier crusts is to just toss in a 1/2 cup of water into the oven while it is baking. The steam transfers heat well and it makes makes the crust not crumble.

I am also working on the cuttings on the top of the loafs, since they make them look so nice! And that works with my philosophy: good looking food tastes better.

Daily Bread

2010-09-02T23:24:00.001-05:00

This is our 1000th post, and in an attempt to mimic one of our favorite blogs, Smitten Kitchen, I took some nicer pictures of my evening bread. Challenges in food photography! The bread itself is a whole wheat and oats cinnamon rasin bread with zucchini. I didn't know before I started making bread that most normal "whole wheat" bread contains just a fraction of whole wheat flour, 1/4th in this case. I have used the zucchini before and if you shred it it makes the bread lighter and moist, but it doesn't give it much flavor.

When making my bread I don't use any recipe, besides the basic ratio of flour to water, salt, and yeast. So far so good, and I have made about 10-12 loafs so far. My one complaint is I can not manage to get that big round artisan bread loaf look yet, and keep getting flatter round loafs. Still good, but that height isn't there. To fix it, I am going to allow more rising, drier dough, and use parchment paper instead of cornmeal.

Bread making like this really is just like brewing. Get the basics right and follow those rules very close. Then, throw in whatever sticks and try it out! Don't worry, the yeast will save you in both endevers.

State Fair 2010

2010-08-30T22:34:00.001-05:00

Here are some of my photos from the 2010 Minnesota State Fair. I am also going to try and use Flickr more, to try and get facebook and the blog closer together:

Vacation!

2010-08-27T12:04:00.003-05:00

I'm home! I've got six whole days off to enjoy the Minnesota State Fair, spend time with Chris and Winnie, see as many friends and family members as possible, and celebrate our one year wedding anniversary. So, no veterinary education for the next few days, but I'm sure there will be lots of pictures to share!

Here's a nice fair photo to start off with:

... and one from my walk with Winnie this morning. So nice to spend time with my puppy!

Blog changes

2010-08-25T15:30:00.000-05:00

Blogger/Google has been updating the look and tech of blogger so I thought we should too. And since Megan has been blogging so much, I need to too! Here are just a few things that I am going to write about soon:

- My commuter bike project
- Pickles, both canned and soured
- Beer projects. State fair beer, cultured Belgian yeast, and a bad batch

More work on the template too. And you can now share stories on various media by clicking any of the links below each post.

Day 5

2010-08-23T00:27:00.006-05:00

Well, I do get some time off, after all, so here's what I learned today...

Thanks to Netflix, I've been watching The Office for the first time. The subtlety of some of the humor never ceases to amaze me. For example, in season 5, there are three episodes in which there is a second office featured (I won't describe why, to avoid giving away spoilers...). The second office contains a goldfish in a bowl. But note, in each episode, there is a different goldfish- one calico, one black, and one gold:

Yes, I am a fish nerd :) Back to work tomorrow!

Day 4

2010-08-22T00:00:00.006-05:00

After having a couple of rotations on emergency overnights and spending some time with urgent care on days, I'm starting to get a good sense of situations when owners should get their pets in ASAP. Sometimes it's safe to wait for a day or two to see if things resolve on their own, but sometimes there just isn't time to wait. For example:

The dog/cat/ferret/etc ingested something potentially toxic, like chocolate, rat poison, ibuprofen, Tylenol, or an entire bottle of Rimadyl chew tabs. Especially in cases where there is known ingestion, pets should always be seen as soon as possible to have vomiting induced. Some people think it's better to wait and see if their pet starts showing clinic signs of toxicity, like vomiting, not acting right, etc, but some toxins can take days or weeks to show their full effects. Rat poison can cause bleeding into body cavities that wouldn't be noticed by the owner until the pet is severely anemic. Ingestion of Tylenol can cause irreversible liver damage that might not make a pet clinically ill for several days. It's always better to get the toxin out by induction of vomiting and try to absorb as much of the remaining toxin by administration of activated charcoal than it is to take a "wait and see" approach.
The pet is seizuring. I'm not sure why owners seem to panic over vomiting and diarrhea but don't seem to be as concerned by seeing their pet have a seizure. We get a lot of phone calls asking if a seizuring pet should be seen right away. Seizures that end quickly generally don't cause much damage (aside from making the pet disoriented/distressed and possibly injuring themselves by falling into or off of furniture, or biting their own tongue). Seizures that are prolonged can cause significant brain damage and other organ damage as the body because hyperthermic. There is no way to know if a seizure is going to be a solitary event or if it will become a pattern. Observation at a clinic is important so that, if your pet begins seizuring again, the seizures can be stopped immediately. There are a lot of underlying causes for seizures, so a thorough exam is important to try to determine why the pet started seizuring in the first place.
Cats who can't urinate. Oftentimes, owners mistakenly think that a cat who is straining in the litterbox is "constipated", when in reality, they are straining to urinate. Cats- especially male cats- can develop blockages in their urethra that completely obstruct the flow of urine. Their bladders can fill to the point that they ultimately die of severe electrolyte abnormalities or bladder rupture. A typical (unfortunate) scenario is that an owner sees their cat straining in the litter box in the morning, leaves for work, and comes home to find a dead cat. Urethral blockage is extremely painful and should be addressed immediately.
Multiple episodes of vomiting in a short period of time, vomiting blood, projectile vomiting, or unproductive retching. Little stomach bugs or a single episode of dumpster diving cause vomiting, but typically not vomiting with the above signs. When we see these signs, we start to worry about problems like foreign body ingestion, gastric ulceration, parvovirus infection in puppies, or GDV (especially in large, deep-chested breeds). This is not "wait and see" sort of vomiting- vet examination ASAP is indicated.
Exotic pets acting abnormal in any way. Aside from ferrets, almost all exotic species are prey animals that are hard-wired to never show signs of disease or injury. If these animals go off of food, start sleeping more than normal, stop vocalizing (if it's a bird), start vocalizing (if it's a small mammal), hide when they would normally be active, or do anything out of the ordinary, it could well be a sign of disease. Often, by the time you can obviously tell there is something wrong, exotic species are severely compromised. Better safe than sorry with exotics!
Pets who have been hit by a car or attacked by another animal. Even if it doesn't look like there are any injuries, many severe internal injuries don't make themselves known right away. Splenic rupture, bladder rupture, or penetrating wounds into the chest are all examples of wounds that a pet owner might not notice, but that could ultimately become fatal. Cats in particular are masters at hiding severe injuries until they decompensate. Don't wait until pets show signs of injury after major trauma- have them evaluated as soon as possible to give them the best shot at treatment and recovery in case there are some hidden injuries.

In general, pet owners should ask themselves what they would do if this same scenario were happening to their baby or toddler. Pets, like young children, can't tell us what's wrong or where it hurts, so a physical exam by a doctor is really important in cases of injury or illness. Early intervention is almost always better than playing the "wait and see" game, and it's certainly cheaper to catch a disease or injury early on when it can be treated on an outpatient basis than to wait until the pet needs to be hospitalized.

And it's always a good idea to have a pet emergency fund (or pet insurance) squirreled away should you need it! Emergency vet visits ain't cheap :-/

Cats really do all these things

2010-08-20T12:34:00.000-05:00

As someone who never really knew what cats were like before getting Taiko, I have to say that I have seen him do every single thing in this video. From Simon's Cat:

Day 3

2010-08-19T00:02:00.003-05:00

OCD could stand for Obsessive Compulsive Disorder (which pets can suffer from), but today it stood for Osteochondrosis (or Osteochondritis Dissecans). OCD is a developmental orthopedic disease that typically causes lameness in puppies 7 to 12 months old, and most commonly affects the shoulder, elbow, stifle, or hock joints. OCD occurs when part of the smooth cartilage that lines the joint surface doesn't form correctly, resulting in a defect in what should be a nice smooth joint surface. The joint ends up arthritic and painful, leading to limping in puppies that should be bouncing off the walls.

In the case today, we saw a 9 month old female Goldendoodle with forelimb lameness. She was painful on manipulation of her shoulder joint, and her radiographs showed the typical abnormalities associated with shoulder OCD. Unfortunately for her, the options for treatment are either surgical removal of the abnormal cartilage or long-term medical management for arthritis. And while dogs usually return to full function after surgery, the joint usually (eventually) goes on to develop arthritis anyway. And the disease is very commonly bilateral, which means her other shoulder will probably become sore soon and require the same sort of intervention.

This is a major financial burden for a pet owner who thought the most expensive surgery her pet would be facing is her spay. It's also disappointing for the owner, who thought her pet might make a competitive agility dog. She also thought that getting a "mixed breed" dog would lessen the likelihood of congenital disorders... but unfortunately, Doodles are just as prone to the developmental disorders of Goldens as are purebreds, and they're also prone to the developmental disorders of standard poodles.

So, today I learned:

it stinks to tell a pet owner that their animal has a limp that won't go away on its own, that requires surgery to correct, and that will give the pet lifelong predisposition to developing arthritis
it stinks to see a happy bouncy puppy walking with a painful limp
it can be hard to convince an owner that, despite being happy and bouncy, your puppy is in pain (otherwise, why would she be limping?)
sometimes pet insurance really is worth it
don't buy into that "hybrid vigor" nonsense that breeders of "designer dog" breeds try to push

Day 2

2010-08-17T22:22:00.002-05:00

Arizona is a very dangerous place to be a domesticated animal. Here is a list of presenting complaints that have come through the clinic while I've been working:

attacked by javelina
attacked by coyote
attacked by Africanized killer bees
ran through cactus
stung by scorpion
bitten by rattlesnake
bitten by spider
Colorado river toad intoxication
Valley fever
Tick fever
heat stroke

So, if you are a pet in Arizona, stay indoors, stay on leash, and don't exercise in the heat!

What I learned today

2010-08-17T00:53:00.006-05:00

Hmm. I've been stuck in a blogging funk lately, writing posts that sound a little too negative to actually publish... I don't want to turn this blog into a spot to vent, but I hate to let it sit idle too!

So, here's my goal for the next month: one post a day about something I've learned- about medicine, or surgery, or Tucson, or communication skills, or whatever. An internship isn't valuable if you don't take time to reflect on it. So, here goes day 1:

Feline malocclusions. A fancy way to say that the teeth aren't lined up right, malocclusions are much more common in dogs than cats because dogs' heads come in a much wider variety of shapes and sizes. The photo to the left is a canine (dog) canine (tooth) malocclusion, in which the lower tooth is contacting the upper hard palate, causing damage to the tissue. Despite being more common in dogs, cats do indeed get malocclusions, and I learned that thanks to my own kitty, Taiko.

Taiko turns 7 months old tomorrow (happy birthday kitten!), and so just finished getting his adult teeth in. I was trying to be a good cat mom and start brushing his teeth early, so that we get used to the routine. A couple of weeks ago, I was brushing and noticed that his breath smelled extremely foul. A 6 month old kitten should NOT have stinky breath (of course, neither should older cats- halitosis is a sign of dental disease as well as many other diseases). I examined his mouth a little closer and discovered that he had a malocclusion of his fourth premolars (teeth #108 and #208, for you Triadan folk). They were set too narrow, so the sharp points of his premolars were digging painful pits into the soft tissue and gingiva of his lower jaw. The foul smell was the infection setting into the gingival tissue. Taiko had both of his 4th premolars extracted and had x-rays taken of his lower first molars to assess the damage caused by the malocclusion. While he had some damage to the gingiva and some horizontal bone loss, he was able to keep his lower molars for now- hopefully we stopped the damage early enough that the integrity of the molars wasn't too compromised. In some specialty dental centers, the sharp points of the 4th premolars can be smoothed down and the teeth can be spared, depending on the severity of the malocclusion. In dogs, some malocclusions can be corrected with orthodontics (yes, seriously).

So, lessons learned:

Always check the occlusion of teeth in puppies and kittens- even babies can have dental disease
Cats get malocclusions too
Foul odors in the mouth of any animal should be investigated ASAP

Guess who's 5 today?!

2010-07-15T03:44:00.002-05:00

Happy Birthday Pooh Bear!

Life after vet school

2010-07-07T11:15:00.000-05:00

Wow- long time, no blog! It's only been a couple of months since graduation, but it feels like forever since the last time I was in VMC. Since then, I've been across Europe and back, up to the cabin, and on a marathon 33 hour drive from Minnesota to Tucson. We managed to squeeze everything that I thought I'd need for my internship (including the cat and the hedgehog) into the Fit. I brought every book and set of notes that I thought might be useful, which turned out to be quite a lot... and poor Chris had to haul all my boxes of books into the new apartment in 108 degree temperatures. Welcome to Tucson!

We spent the first week in Tucson exploring, looking especially for the best food Arizona had to offer. We found the best tacos at the Taqueria Pico de Gallo, a little hole-in-the-wall that used to be a taco stand. They've since grown to have enclosed seating, but you still bus your own food and clean up after yourself. They make fresh corn tortillas while you wait, and serve a type of pico de gallo made of big chunks of fruit covered in chili powder and salt. Yum! The farmer's markets had the best tortillas and salsas, although fresh produce is sort of lacking at this time of year.

We also discovered tamales, delicious concoctions of corn masa and some other delicious filling (like peppers, mushrooms, corn, cheese, etc), wrapped in a corn husk. We visited the Tucson Tamale Company based on an article from roadfood.com. When we told them we were new to Tucson and to tamales, they served us a free tamale and taught us how to prepare and eat them. Delicious, cheap, and easy to prepare? We were hooked, and have a freezer full of tamales to show for it.

After a week of getting oriented to Tucson (and trying to adjust to the temperatures), it was time for Chris to head back to Minnesota and for me to start my internship. I was a little scared that after six weeks of thinking about anything but veterinary medicine, I would be completely useless as a new doctor. Of course, I hadn't forgotten everything, but I've also been eased into my role as an intern. We spent our first week getting oriented to the clinic, learning where things are and how things work. The next week, we split into our separate shifts- I started on days, and the other intern started on nights. We'll spend two weeks on each rotation until October, when our rotations switch to three weeks long.

So, what did I learn during my first couple of weeks as a doctor?

private practice medicine and university teaching hospital medicine are very different things- at the university, most people are coming in knowing there's something really wrong with their pets. In private practice, someone might come in for what they think is a routine wellness exam and leave with a diagnosis of heart failure or cancer. You surprise people a lot more often in private practice.
sugar gliders make terrifying sounds and will definitely bite you given half a chance.
my hands, generally pretty steady through things like surgery or blood draws, get shaky during euthanasias.
good technicians are worth their weight in gold (I already knew that, but now that I'm a doctor it's even more obvious).
During vet school, I got very good and thinking very thoroughly- we saw relatively few cases each day, so there was a lot of time to dig into the disease, the pathophysiology, the pharmacology of the medications involved, or all the different possible approaches to the surgery or procedure. At my clinic (and in most private practices), the pace is much faster and I'm going to have to get a lot better at thinking on my feet and trusting the knowledge base that I built during clinics.
puppy and kitten visits are important antidotes to euthanasia appointments.
I'm still not used to being called Dr. Schommer, but I kinda love it when clients call me "Doc".
tortoises can be hypothyroid. Who knew? (I feel like "How can you tell your tortoise is hypothyroid?" is sort of like "How can you tell your accordion is out of tune?").
baby hummingbirds are the most adorable animals ever.

I think everyone who went to an internship after graduation was a little nervous about what their clinic would be like- we all heard stories about programs that use interns as slave labor rather than doctors, or programs where the residents get priority for interesting cases, procedures, surgeries, etc and interns get whatever is left over. I've only been at my clinic for a few weeks, but I feel lucky. There aren't any residents to compete with, the doctors are supportive and always open to answering questions, and we're treated as full-fledged doctors (even if we're still just partially-fledged doctors ;) ).

Tonight, I start my first stretch of overnights. Wish me luck!

Fitting in the Fit

2010-06-05T16:35:00.002-05:00

It worked!

Megan's Graduation

2010-05-02T10:39:00.002-05:00

It has been quite a trip, but last night Megan graduated from the University of Minnesota with her Dr. of Veterinary Medicine. We started writing here on October 16th, 2006 during the first few weeks of Vet School. So much has changed since then! Megan has put in countless hours these past four years, and has truly transformed herself into a doctor. We are looking forward to more good things to come, but first here are some pictures from last night!

Last day, last patient

2010-04-30T07:21:00.003-05:00

This big beautiful girl is my last patient of my vet school career. What a way to finish up!

Action shots at the dog park

2010-04-21T22:59:00.001-05:00

I got a new light weight lens today for the camera for travel. We hit the dog park to test it out:

Suddenly at the end

2010-04-18T21:58:00.004-05:00

It feels like yesterday that I was getting my white coat and heading into clinics for the first time, but suddenly the new fourth year class is starting and I'm just about to begin my final rotation. I get to leave the Teaching Hospital and head next door to the Raptor Center for my Companion Birds rotation. Companion Birds means lots of hands-on learning about avian restraint, bandaging, fracture fixation, and (for some reason) a morning of birdwatching (hey, I'm not complaining).

I've been trying to come up with a blog post that sums up my fourth year, or vet school in general, or all the emotions I have surrounding my upcoming graduation, but nothing comes out sounding right. It's one big mixture of exhaustion, anxiety, and excitement, and I feel like this year has flown by so fast that I've hardly had time to digest it all. For now, I'm just trying to enjoy my remaining time with my classmates and appreciate lovely things like spring, the adorable antics of Winnie and Taiko, and my cute new (er, used) Honda Fit. Only two weeks to go, can you believe it?

Black Pepper Eclipse Stout

2010-04-10T21:08:00.002-05:00

I opened a new homebrew today. "Black Pepper Stout" that I then re-named "Black Pepper Eclipse Stout" after doing this with my Surefire G2L, 80 lumens, tactical flashlight. That little thing will nock out your vision (temporarily) if you shine it in your eyes, and you will be seeing spots for a long time. But when you use the beer as a filter, you can see nothing.

I knew I made it dark, but I you can always see something!

Tastes fantastic too. The black pepper adds a wonderful flavor, that is not spicy but very up front. Kind of like you just ground a bunch fresh into some soup, and you can smell the dust. State Fair 2010?

Play time

2010-04-08T19:16:00.005-05:00

Winnie and Taiko are getting along! They are learning to play together, and it is incredibly funny. Taiko is still about 8x smaller than Winnie, so he gets tackled and tries to get out/paws at her head. He ends up covered in dog slobber, but he goes back for more each time!

Update: Cat in a hole!

Taiko Slideshow

2010-04-02T11:48:00.001-05:00

Taiko

2010-03-30T21:37:00.005-05:00

Welcome 太鼓! 10.5 weeks old. We are going to keep Winnie and him separated until this weekend so they can get used to each other being around. Then hope they get along! So far he has been very sweet and playful. He hops on his hind feet a lot, and perked up when he heard drums on the radio. Thus, his name. Lots more photos and video to come I am sure!

Meow?

2010-03-29T21:53:00.001-05:00

Matching luggage

2010-03-29T10:11:00.003-05:00

Oh yay, we got married and now have matching luggage... The North Face Bace Camp Duffel. Well, Megan has a red one and I have my trusty old yellow one from 2003. I traveld with it to China and Japan, then Megan used it to travel to Ecuador, then I lent it out to a fried to travel to Greece, and I lived out of it in NY. Recently it had been serving the lowly life as a gym bag, but now it is back to the traveling life again! Since it has held up so well since then (it is in perfect shape still) we decided to buy a 2nd one for our trip to europe.

So matching luggage yes, but this is our kind of bag! That also means we are going to be traveling very light, which is good because we will be moving often.

Since I love google maps, I have been using it to draw out routes, and this map below is what we have settled on for now. London for a few days, then take the train to Oxford and rent a car to drive around the pastoral Cotswolds region (and perhaps ride some horses), see some castles like this one, and then end up in Bristol. From Bristol we will take a cheap flight over to Paris where we will probably stay for a few days, and then take the train on to the old town Bruges Belgium, and then on to Amsterdam to catch our flight home. Hopefully we have left enough wiggle room to take us as the wind blows too.

We are still fishing for advice/tips. So if you have been any of these places, let us know!

View Megan and Chris 2010 Euro Bash in a larger map

Rotations #20, #21, and #22

2010-03-22T20:43:00.000-05:00

My fourth year is chugging along, and I suddenly only have a handful of rotations left! Here are my summaries of the past few rotations...

Rotation #20: Small Animal Surgery

I had my second (of two) SAS rotations just two blocks after my first SAS. One of the surgeons asked me how I felt about my second Surgery, and I said I was "doing a lot less pointless running around, and a lot more useful running around." The rotation was still demanding, but at least I had a better idea of what I was responsible for. I improved my orthopedic exam skills a lot, and finally palpated my first cranial drawer (an abnormal physical exam finding associated with a ruptured cranial cruciate ligament, the canine equivalent of a torn ACL). We got to see a few interesting cases, like a string of brachycephalic (short-nosed) dogs who needed their soft palates shortened to help improve their breathing, a naughty Goldendoodle who ate a rock that got stuck in his intestines, and a dog who was romping around his backyard and sliced through a tendon on his wrist when he slipped on a sharp piece of ice.

I did learn a lot on my SAS rotations, even though I likely won't be doing most of the more advanced surgeries personally... It's nice to have an idea of what surgeons are capable of doing and what's involved in the aftercare, since that's what I'll need to know to be able to advise clients in the future. That said, I can't say I'll miss the 6 AM to 8 PM treatment duties, writing up surgery reports, or getting called in at 1 AM on a Sunday for emergency surgery!!

Rotation #21: Cardiology

It's not hard to see how people fall in love with cardiology. Sitting in a dark room, watching an echocardiogram (ultrasound of the heart) display the intricate cycle of contract and relax, or watching the electrical impulses of the heart tick by on an electrocardiogram (ECG or EKG) is mesmerizing. It's even more amazing to give a drug and watch those rhythms change, or put in a device to occlude an abnormal shunt and watch the blood flow shift from turbulent to smooth. Cardiology sees a lot of pediatrics and geriatrics- babies with congenital abnormalities and seniors with congestive heart failure or other chronic degenerative heart disease. Some of the congenital cardiac diseases are really rewarding to treat because they can pretty much be fixed and the animal goes on to live a normal life. Patent Ductus Arteriosus (PDA) is a good example. A PDA is a defect in which the ductus arteriosus, a normal fetal vessel that shunts blood around the lungs, fails to close at birth. This results in abnormal blood flow through the heart and, left untreated, progresses to heart failure within the first year or two of life. At the U of MN, a device called an Amplatz Canine Duct Occluder (ACDO) was developed to allow minimally-invasive surgical correction of PDAs. One of the cardiology residents even helped to develop an ACDO that is small enough for patients under 3 kg (which many PDA patients are, as small breed dogs are predisposed to PDAs). With ACDO occlusion, PDA puppies grow up to be normal active adult dogs.

Other congenital defects aren't so fun- subaortic stenosis (SAS) is a disease seen in larger breeds like Golden retrievers. This is a condition in which there is an abnormal narrowing near the aortic valve, which causes the heart to pump harder than normal to push blood out into the aorta. Dogs with severe SAS can develop heart failure at a young age, whereas dogs with mild or moderate SAS can be asymptomatic for months or years. The sad thing about SAS is that we can't do much about it other than manage the congestive heart failure associated with it. Owners of dogs with SAS have to be prepared to face complications of the disease, which include the possibility of sudden death. No fun at all.

I learned a lot on this rotation about the most common heart diseases and how to manage them, and also developed a strong appreciation for veterinary cardiologists- I'm glad someone out there is brave enough to do heart surgery!!

Rotation #22: Externship!

I spent the end of February on externship at a local integrative medicine practice. I loved loved loved it- after all the complex diseases, awful fractures, poor prognoses, and zebra diagnoses that we see at the U of MN, it was so nice to see patients presenting for annual checkups and vaccinations. I got to neuter my first client-owned animals (and spent about 24 hours post-surgery worrying that things would go bad, until calling the owners and finding out that the dogs were recovering just fine). The techs at the clinic referred to me as "Dr. Schommer", which was both awesome and terrifying. It made me really excited to get out into practice! (note regarding the photo: despite popular opinion, vets really don't get to snuggle with puppies all day... but we do go a little crazy for puppies when we get to see them :) )

Rotation #23: SAM-B

This Medicine rotation was the fourth and final Medicine for all of the students on the rotation block. We all thought that maybe we'd feel a little smarter than we did on our first Medicine, and I'm sure we all were... But, Medicine being what it is, we still all ended up with patients who threw us for a loop. We saw animals with multiple concurrent disorders (diabetes and Cushings disease, hyperthyroidism and GI lymphoma, congestive heart failure and chronic renal failure). We saw animals that presented with one problem and got diagnosed with something completely different (like a dog with regurgitation due to a supposed esophageal stricture, except that he actually had a huge foreign body in his stomach). And then we had animals with diseases that should have been really serious go trotting out of the hospital the day after admission, and animals that had diseases that are usually self-limiting die due to really rare complications. I guess the theme of this SAM block was to keep any of us from getting too cocky or confident, and remind us that there's a reason they call it "medical practice" and not "medical perfect".

Next I'm on to Dentistry, then General Practice, then Companion Birds, then graduation!!

Healthcare!

2010-03-21T17:19:00.003-05:00

Watching it live. What an amazing accomplishment!

And here is photo of when it happened, just a few seconds ago.

216 votes.

.5

2010-02-28T23:03:00.000-06:00

Megan and I were going to celebrate our 1/2 year anniversary, but we realized there is no February 29th! Not until leap year that is.

So, here is my favorite "bad" photo from our thousands of photos. I have no idea what is going on, I must just be pointing to something in the grass, but it looks like I am viciously scolding her bouquet.

I also need to get our photos on line for people to look at too! So many projects, but I will get to this one soon.

Banksy video

2010-02-20T14:19:00.003-06:00

Banksy the hedgehog at his finest. I suggest clicking on HD and then going to full screen for the maximum effect!

Europe?

2010-02-13T21:44:00.003-06:00

Megan and I are planning on taking a trip to Europe after she graduates as an extra honeymoon/post-graduation celebration/pre-internship hullabaloo. Basically this is our chance for some travel, and we are going to grab it!

But, we have no idea where to go. I know we can fly into London and out of Amsterdam for a good price, and we are thinking about spending time in the UK, France, Belgium, and the Netherlands. With additional thoughts about Prague, Italy, and well... everywhere else. I want to get to places where we can rent bikes to tour, and am looking for great food. Megan likes historical sites too.

So let us know if you have any great insights!

Match Day!

2010-02-08T17:50:00.001-06:00

Congratulations to Megan for getting an internship in Tucson Arizona! It sounds like a great hospital, with a great program and we are very excited to learn more. Megan's first day would be June 16th, and the program goes for a year and a week. The photo on the left is downtown, with the hills behind on one of their rare snowy days. I could have put up a photo of the many cacti but I am sure you will see many of those in the future! (Average high, 100˚ in June)

So if anyone knows anything about Tucson, let us know. So far I have learned:

how to spell "Tucson" (Not Tuscon)
that rent is cheap
It gets hot in the summer, and they have a monsoon
but it is still a desert climate due to its high evaporation rate
the surrounding hills are very pretty
it has a big Wiki page that I am going to read up on

Congratulations!

Superbowl ads

2010-02-08T17:45:00.000-06:00

Great Superbowl last night. The Saints played inspiring football!

But the ads this year were odd, and not too many good ones. I was struck by how explicitly many companies are attempting to define what a man should be this year, and of course align their product with that identity. The Dove commercial treats male suffering as a comedic and heroic triumph - so buy girls soap because you don't need to show off in the shower! The Dodge commercial is the opposite, and treats suffering as inevitable and petty - so buy this car to escape your troubles. Sure it is supposed to be tongue-and-cheek, but I find it incredibly depressing. It is probably effective marketing too. Everyone - from politicians to car companies - are taping into some boiling rage in America where you are being victimized by everyone and can trust no one. See Tea Party et al. Anyway, watch the clips yourself and see what you think!

The Plow Man Comith

2010-02-01T09:54:00.003-06:00

Lastnight Megan and I saw "9" in wich humanity has been wiped out by robots, save for a few rag-doll creations who are tormented by the self replicating evil robot brain. It was based off a great short film by the same name, that you can watch here.

So big mechanical apocalyptic robots chasing small little creatures around and trying to eat them.

Then, later on we encountered one of the downsides of our apartment perch. Sure nice men from the city of St. Paul (I think) with huge machinery will come and plow your sidewalk for you for free. But, you don't get to decide when they do it! at 12:00 they rumbled in, with a huge plow, a little bobcat, and a few plow trucks to clear off the bus stop and corners. They would draaaaaaaaaaaaag their shovels over the pavement and BANG them down again, shaking the whole building! Needless to say, we thought that the giant robots had come to smash our house down and eat us. I shot some video of their work, which was quite interesting to watch.

I will make you work!

2010-01-31T21:01:00.012-06:00

The Subaru was doing its best to die at the end of this week. First on Thursday it started then stalled in the Rainbow foods parking lot, forcing me to take the bus home (thank you #16 route!) and going with Megan in the Volvo to fetch it. Fortunately it started after sitting for a an hour.

Then on Friday, I smelled a strong raw gas odor when I was on my way to work, and I opened the hood and found gas dripping onto the engine! I looked up information, and I found that Subaru had recalled the 2002-2003 Impreza WRX (the turbo version of our car) for, "fuel seepage during cold start of the engine under extremely cold temperatures." This was due to misaligned and too short fuel lines connected by a too short hose - which was exactly my problem and was what caused it to die on Tursday. So I made an appointment even though Subaru said I wasn't covered by the recall, but they would see what they could do. Meanwhile, the lovely folks on the internet suggested that I simply tighten the clamps holding the hose on since it was so easy to get too. I did in the parking lot, and that fixed it! Yay!

Then, as I pull out of my parking spot, the steering gets really heavy and warning lights start going off all over. It turns out the V-belt tensioner bolt snapped, leaving power steering and the alternator disconnected. This was completely unrelated to the first problem of the day. But I was determined to make it home, and so removed the alternator, got the broken bolt out, walked to the hardware store, bought a new bolt, walked back and put the whole thing together again. I was not going to let that car ruin my day!

So now it is running and starting just fine. I suspect the broken bolt was my fault since I installed the new alternator myself, but I can't be sure. The whole engine was shaking quite badly since 1/2 wasn't getting the right amount of fuel, and that might have had a hand it in too.

I do find it amazing that the entire car can be paralyzed because two small screws were two turns loose each. There is some lesson in that! I plan on completely replacing all the troubled tubing and clamps when the weather warms up.

EDIT: and for future reference and for Google's sake, the recall code and NHTSA Action Number: PE04002 and our car is a 2002 Subaru Impreza Outback Sport

Rotation recaps

2010-01-23T10:10:00.011-06:00

Seeing as how I've gotten way way behind in posting about my rotations, I have a bit of catching up to do... So, here's the short-and-sweet version of my last 6 rotations:

Rotation #14: Avian and Exotic clinic externship
I spent two weeks in Indiana at a practice that sees just about everything but cats and dogs- including parrots, rabbits, ferrets, opossums, skunks, zebras, turtles, and arctic foxes. They do all the things that a normal practice does, like spays and neuters, toenail trims, and managing diabetic patients, but they also offer services for the exotic patient's, er, special needs- things like beak trims for birds and turtles/tortoises, de-scenting surgery for skunks, and "bird divorce" for birds who have accidentally sexually bonded with their human owners. Super fun rotation! I got to see so many things that we don't get any exposure to at the U of MN since our teaching hospital doesn't generally see exotics. This externship reaffirmed my desire to specialize in exotics and inspired me to apply primarily for avian/exotic internships for 2010-2011.

Rotation #15: Small Animal Medicine-B
This was my third Medicine rotation, and like the other two, I got to see a fair number of patients with vomiting and diarrhea, diabetes and other endocrine disorders, and coughs/sneezes. But, also like the other two, this one had an underlying theme. My first SAM was all about infectious diseases like Anaplasmosis and Blastomycosis, my second I saw a lot of chronic diseases like immune-mediated hemolytic anemia and diabetes, and my third SAM I saw a lot of urinary system diseases. It probably had a lot to do with the fact that we were on with Dr. David Polzin, one of a tiny handful of veterinary nephrologists (kidney specialists). People will drive a long way to see him, so we got to see quite a few really rare kidney conditions, along with the more common urinary tract disorders like bladder stones and urinary tract infections. It definitely helped me brush up on my renal physiology!

Rotation #16: Radiology
Oh, radiology. Every vet school seems to have a subject that causes vet students much grief throughout their didactic years- for some it's pathology, others pharmacology, and at the U of MN, it's radiology. Part of it is because the senior radiologist is a radiology genius who can somehow make an anatomical abnormality or pathologic change out of the most subtle differences in shades on a radiograph... and the other part is that he assumes other people can see those differences too. Even though the classes were challenging, I actually really enjoyed radiology, and the rotation was even better. There's something very satisfying about being able to tell what's wrong with an animal within a few minutes of taking the x-ray. Of course, radiologists have to be the ones to make the calls like "That looks like a tumor in the lungs" or "That abdominal mass has gotten bigger", which is really difficult in a specialty that can be as subjective as radiology ("Is that tiny slightly whiter patch maybe a tumor, or just an artifact?"). Then there are the really annoying cases where the animal is really sick, but the radiographs look completely normal. Hmph. Either way, I loved the half-science, half-art nature of radiology and learned a lot on the rotation.

I also took boards during this rotation. I prepared using the new Veterinary Board Review Flashcards (hint: they work GREAT with a Trivial Pursuit board!), plus I completed all of VetPrep (approximately 2 bajillion NAVLE-style multiple-choice questions). I tried to use some other study tools like the A to Z Guide and the Ohio board review notes, but they didn't really work for me. I completed the NAVLE in about 3 1/2 hours, even though I took a few 10-minute breaks and tried to force myself to slow down (most people take 5 or 6 hours to finish). I spent the next month panicking that I'd failed because I didn't read the questions closely enough, but as you know, I got the good news last week that I passed! I guess I've always been a pretty fast test taker...

Then, I also had to complete and send in my application for the VIRMP, which is the organization in charge of assigning vet students to internships. I applied to 10 internship programs, one of which withdrew from the match before I had a chance to rank them (hmph, no fair). After applying, we had to rank the programs (first choice, second, etc). Then the programs rank their applicants. Then all the data goes into a big computer who puts them through some fancy algorithm and pops out the program that came closest to matching your rank list. On February 8th (our "Match Day"), we'll be notified of where we matched (or if we didn't match at all), and thus where we'll be spending the next year of our lives. Not all vet students apply for internships, but I'd say my class has 15 or 20 people participating this year. It will be a big day!

Rotation #18: Animal Humane Society externship
I spent two weeks just before Christmas at the Animal Humane Society in Golden Valley. Most of my time was in the OR, performing spays and neuters and other minor procedures on incoming animals. I learned a TON and became a much more confident surgeon. I got to see a really wide range of anatomy (big dogs, little dogs, baby cats, pregnant cats) and experienced almost every common complication that can occur during surgery (except for dropping a pedicle... still haven't done that one yet). I got better at anticipating complications and learned how to be a more efficient surgeon without compromising any surgical technique. Of course, I also fell in love with a bunch of super cute animals and tried to bring these little kittens home at least three times, but... sigh, not the right time for a kitten in our lives, yet.

Rotation #19: Small Animal Surgery
The major branches of vet (and human) med are surgery and medicine. Basically, if you can treat a problem with pills or shots or dietary modification, the patient goes to see internal medicine. That's why the Medicine service sees the animals with endocrine disorders like diabetes, infectious diseases like Lyme, or chronic problems like Inflammatory Bowel Disease. If the problem can be corrected surgically, then they go see the Surgery service (duh, right?). Sometimes problems fall into both categories and the lucky patient ends up seeing both services- like a pet who sees Medicine for bloody urine, and they determine that it's being caused by bladder stones that need to be surgically removed.

Anyway, on my Surgery rotation I got to see some cases that overlapped with what I've seen on other services, but most of my patients had problems that I'd never seen before- things like ruptured cranial cruciate ligaments (analogous to torn ACLs in people), hip dysplasia, and slipped intervertebral discs. I also got to see a number of Oncology patients who were having surgery to remove cancerous tumors- one dog had most of his tongue removed (amazingly, dogs can learn to adjust to a life without a tongue), one dog was being recut after a previous surgery failed to remove the entire tumor, and a cat had a benign tumor inside his ear. The rotation itself was pretty all-consuming, since I needed to be at school early to examine patients, spent all day either in surgery or seeing appointments, then spent all evening writing up surgery reports or discharge letters. I was lucky enough to get called in on New Year's Day for not one, but two surgeries in a row for dogs who had ruptured intervertebral discs and needed emergency surgery to regain use of their back legs (without surgery, they likely would have been permanently paralyzed- which isn't a death sentence, as most dogs can learn to use carts- but most people would rather have a dog who can walk). Lucky me! The rotation was exhausting and trying, especially with a few really sad outcomes, but I learned a lot and got a lot better at juggling multiple cases at a time.

Rotation #20: Behavior Medicine
I was so excited to have my Behavior rotation, and it didn't disappoint. Behavior problems are sort of underappreciated in veterinary medicine, even though they can have major effects on a pet's role in the family and are the #1 reason that people surrender animals to shelters. Behavior was pretty much the exact opposite of surgery- instead of juggling four patients at a time, seven days a week, Behavior sees about two patients a day, three days a week. Appointments last from 2 to 4 hours, and there is a TON of client education involved. I loved being able to help people understand why their pets were doing what they were doing. They would come in thinking their animal's issue- biting people, attacking other dogs, peeing all over the house- were completely random, and we could help them see how the behavior developed and what the underlying cause was. There were a lot of really satisfying cases, but some sad ones too. Just like physical problems, some behavior problems can't be managed easily, and things owners have to do to manage them affect the pet's or the human's quality of life so much that it's just not worth it. But, there were enough cases where we could see the effects of helping an owner understand their pet, and helping the pet become a positive force in the home again.

Also, I can now officially say that I've seen two instances where people used techniques learned from Cesar Millan with really severe consequences. One person tried to discipline her dog by doing a "scruff grab" (you know, using your fingers like a wolf would use his teeth.. right?), and the dog turned and bit her. One person alpha rolled her dog when she growled at kids, and the next day the dog lunged at a child passing by with no warning. There's a reason that his show starts with a disclaimer to "not try this at home". In both cases, the owners interpreted their dogs' behavior as being rooted in "dominance", when in reality both dogs were incredibly fearful and were trying to get the scary things to back off. Rather than punishment, these dogs need to learn how to change their underlying emotional response to the world around them, and need to learn that they can look to their owners for guidance. Does a dog want guidance from someone who causes them fear by throwing them on the ground? Nope... they need to first avoid all situations that make them scared, become desensitized to scary things through a long process of behavior modification, and sometimes need anti-anxiety medication to bring their anxiety levels down to a place where they're capable of learning (although that last one is really hard for some people- even though few people question whether diabetic patients benefit from insulin, or arthritic patients benefit from anti-inflammatories...). But alas, I guess 6 months of behavior modification doesn't make very sexy TV compared to 15 minutes of Cesar's "dog psychology".

Next, I'm on to my second (and final!!!) Small Animal Surgery. We're down to 98 days to go til graduation (on May 1st)... I'm in the home stretch!

Beet Wheat

2010-01-20T14:36:00.003-06:00

The first new beer in a while came out of the pot this weekend. It is being called "Beet Wheat" in honor of the 2 large beets that were included in the boil. Check out that wild color! So far it smells peppery and earthly, with a bright hop aroma. I will know how it tastes in a few weeks.

Predictions

2010-01-20T10:38:00.009-06:00

In the light of the game changing election of Scott Brown to fill Ted Kennedy's vacant Senate seat in Massachusetts, I think it is time to lay down some political predictions, in order of my certainty.

#1 It is a safe bet that Scott Brown (R-MA) will be running for president in 2012, and right now I would even give him the odds for the nomination. Check out his killer ad. This is George Bush in 2000 stuff. He is Mitt Romney without all the Mitt Romney. But we'll see if Republicans can contort around his support for Massachusetts "commie" healthcare, or his nude Cosmo photo shoot! (Link Possibly NSFW) I am betting they can.

#2 Heathcare reform is deeply damaged, and just a few feet from the finish line. The only question now is if it can survive. Since Democrats are too meek to confront the insane abuse of the filibuster, this Village Voice headline gets it right on, "Scott Brown Wins Mass. Race, Giving GOP 41-59 Majority in the Senate." Democrats are going to wait patiently for Brown to come to Washington. Then they are going to try and get "bi-partisan support" for something, which will of course fail, and then who knows what will happen. If history is a guide, no more reform attempts until after 2020 at least.

#3 Obama will become far more aggressive. He has been sounding more like he was during the campaign in the past few weeks. Perhaps a loss will wake him up to start moving things faster. What has he got to loose?

#4 Obama will become far weaker and turn over the white house keys to Olympia Snowe, causing him to loose to Scott Brown as bad as Martha Coakley did. The alternate to #3. I hope not.

In other words, the glass is half empty and I think it has sprung a leak...

NAVLE!

2010-01-15T17:18:00.003-06:00

It's official- I've passed the national boards!! It's all downhill from here 'til graduation!

I can has a book deal?

2010-01-11T15:05:00.005-06:00

Well, not quite, but Winnie is going to be published! The offshoot of the cat-centric "I can has cheezburger" blog, the dog focused "I has a hotdog" is publishing a book of their best lol dogs, and Winnie is in there with the photo above! The book is scheduled for an April 20th release date.

Congratulations to Winnie for being the best wave Nomer I know! And to Megan for making the caption. And possibly to me for taking the photo (I'll have to check that though)

The Third & The Seventh

2010-01-06T16:32:00.003-06:00

Alex Roman. He made this 12 minute film, and called it "The Third & the Seventh" and blew my mind. I would highly recommend going to Vimeo and watching this HD and full screen.

And just remember, this is 100% computer graphics. CGI. Not real.

The Third & The Seventh from Alex Roman on Vimeo.

Surgery Rotation

2010-01-01T23:06:00.004-06:00

To give everyone a feeling of Megan's schedule durning this Surgery rotation, I have made up a list roughly detailing her day today as I understand it:

4:30 AM - Wake up
6:00 AM - Arrive at school

Patient Care
Surgery
Write up
Surgery
Patient Care
Lunch
Surgery
Surgery
Write up
Write up
Patient Care
Dinner
Surgery
Surgery
Write up
Patient Care

11:45 PM - Arrive at home.
12:00 AM - Sleep.

14 days of this. Phew.

Please Pass Healthcare Reform

2009-12-21T10:25:00.007-06:00

Heathcare reform in the Senate passed a major, and perhaps the largest remaining hurdle late last night with a 60 vote filibuster-busting vote. I think this is great news, and it means we might have a signed bill by the end of the week.

But recently with the demise of the public option or medicare buy-in the Left has now split in half with people like Keith Oberman and Howard Dean et. all. sounding like Health care reform was only about the public option the whole time, and that this will be a "bail out" to the insurance companies. Never mind that this bill is more liberal than Dean's own plan than he ran on in 2003-04! And if the deal with the devil means increasing insurance companies profits by 1% a year for the next 10 years to insure 10's of Millions of Americans, well count me in.

So this isn't a "perfect" bill, but the history of our modern social programs is an ugly one. Social Security excluded agricultural labor, temporary workers, domestic service, government employees, and many teachers, nurses, hospital employees, librarians, and social workers (also known as women, minorities and the poor) when it was enacted in 1935. Very progressive. This healthcare bill will get us an exchange, with required transparency, subsides for those who can not afford it, much tighter regulations, and price controls. I will let Ezra Klein add to that. Further, it creates a framework for a government run national option to be inserted into the exchanges later on, which is worth fighting for.

And if this fails in 2009 we will have the exact same healthcare system I thought we all hated for another 20 years. It happened in 1975, it happened in 1992, and it would certainly happen this time. Democrats are going to loose seats in 2012. There will be more Joe Lieberman's, and there are currently lots of Joe Lieberman's in our highly dysfunctional "60 vote" Senate already! Obama won't be president forever, and odds are his successor with be a Republican. Meanwhile the Insurance industry will continue to live happily unregulated, and America's health care system will continue to become more and more expensive and inaccessible.

The death of this bill would be tragic. People need healthcare in this country, and the current system is literally killing us.

EDIT: And speaking of money, here are some estimated costs for insurance, and total risk for families, under the current system compared the the new bill. And this ignores those who today would be denied coverage, whos risk goes until bankruptcy.

my current externship

2009-12-17T17:27:00.000-06:00

It's Christmas time!

2009-12-08T22:04:00.002-06:00

A view from our perch.

I have been humming this song by Sufjan Stevens all day. Here is someone's homemade music video for it:

If that gets taken down, there is always lala:

Hey Guys! It's Christmas Time!...

Busy busy

2009-12-06T14:02:00.004-06:00

I've fallen behind in my rotation updates again, but I promise I'll post about blocks 14 (avian and exotics externship), 15 (my third Internal Medicine rotation), and 16 (radiology) soon! For now, I'm putting the finishing touches on my application for an internship and starting my last-minute cramming for boards. I feel pretty confident about small animal and exotic medicine questions, but pig diarrhea, equine colic, anything about poultry, and epidemiology are all still fuzzy. Study study study!

Poor Winnie wants to know when I'll have time to play again...

Crossing Over - MN/WI CX video

2009-11-16T11:20:00.003-06:00

I am way behind on my Cyclocross updates, and now the season is over! I will post about the Crossniacs Fall back that we hosted, the great St. Olaf race, and my intro into the 45min cat 3 race at the state championships later, but for now here is a fun video called, "Crossing Over: Why I Stopped trying to Explain Cyclocross To Family and Friends" about the racing in the region. Make sure to watch at 1:18 for our super local superstar on the seat post cam.

Rotation #13: Public Health

2009-11-09T20:09:00.005-06:00

For vet students, Public Health is a bit of a catch-all subject that includes any situation in which humans and animals interact and may or may not spread diseases to each other. Our Public Health classes have taught us how to recognize lots of different zoonotic diseases (diseases spread from animals to humans) and how we can control the transmission of those diseases. We've also learned about food safety and production, human-wildlife interactions, and how the government prevents and monitors for diseases such as Foot and Mouth. The Public Health rotation was more about seeing these ideas in action through a series of field trips around the Twin Cities and beyond.

Our first visit was to the St. Paul Animal Control, who are responsible for protecting people from animals (as opposed to the Animal Humane Society, who protect animals from people). Animal Control are the people who come to check out dangerous dogs, deal with nuisance wildlife, pick up dogs and cats who are running loose (the traditional "dog catchers", a la Lady and the Tramp), and respond to complaints about people keep illegal pets (like tigers, bears, or in St. Paul, more than three chickens). Our trip to Animal Control was short, but we saw a number of dogs that were examples of the worst sorts of trauma humans can inflict on dogs. Terrified, leaping at their cages doors with barred teeth and fierce barks. No dogs should ever have to feel that scared when they see a human.

The next day was food safety day, with trips to two very different meat processing facilities. The first was to Lorentz Meats in Cannon Falls, MN, a small USDA-inspected slaughterhouse. This is the same slaughterhouse mentioned in Michael Pollan's "The Omnivore's Dilemma," in which the Lorentz family was commended for their commitment to local food and local farmers, as well as high standards for animal care and welfare. The Lorentz facility has a glass abattoir, meaning that anyone who wants to come see the process of slaughter from start to finish can. I was a little unsure of how I would react to seeing the animals killed, as the only animal deaths that I've seen have been through euthanasia- but after watching the process several times, I was surprised at how gentle and fast it all was. First the animal was standing there quietly, then the next second it was down. No screams, no thrashing, just poof, gone. The rest of the process wasn't much different than performing a necropsy, except that the workers were much much cleaner than we were and much more efficient.

We followed that trip with a visit to a live animal market in South St. Paul. While facilities that produce meat for sale to the public have to be USDA inspected, facilities that slaughter or process animals for one's personal consumption are considered exempt from inspection. The most common example of this would be the places that process deer from hunters. In South St. Paul, you can walk into Long Cheng Livestock Market, pick out a live chicken (or pig, goat, sheep, or cow), hand it to a worker who will slaughter it for you, and get it back to finish the rest of the process yourself. The market serves primarily immigrants who are unused to buying meat already processed or who want their animals handled or slaughtered in a specific way. At first the whole place is a little shocking, but I have to admit, I admire anyone who has such an intimate connection with the food they eat. We're often so distanced from where our food comes from that it was quite a change of pace to see people- even whole families with kids- come and take such an active role in their food. From a public health standpoint, while the facilities aren't as pristine as Lorentz Meats, the meat also is much less likely to stay in refrigeration for extended periods of time, reducing the risk of bacterial growth. People who are involved in the processing of their own meat are also more likely to have been exposed to pathogens in small amounts, likely building up some immunity to organisms that might otherwise make people very sick.

Bet you didn't know you could shop for a live chicken in St. Paul, huh?

After our day of meat processing, we checked out some of the interactive animal exhibits at the Minnesota Zoo. The Family Farm exhibit offers several areas where kids and parents can pet animals like goats, sheep, and chickens. We talked about what diseases each species can spread to humans and looked at how the zoo designed each animal enclosure to keep both animals and people safe. Then we went to visit the dolphins because.. well, dolphins are adorable. ;)

We spent one morning at Urban Academy in downtown St. Paul working with third and fourth graders. Each group of three vet students was assigned to a topic like "What Vets Do" or "Food Safety". I ended up with "Hand Washing," which was really more of an exercise in wrangling 15 fourth grade girls into one bathroom than an educational experience. At least they all ended up with clean hands!

We visited the Animal Humane Society in Coon Rapids to talk about how shelters manage their unique population of cats, dogs, and pocket pets, and how they work to prevent disease transmission. As always, it was a bummer to see so many homeless cats and kittens (and everything else too, but there seemed to be cats pouring out of every corner). They said during busy months, they take in 2,000 cats a month... ouch. Diseases that are normally simple, like upper respiratory infections, can become life threatening in a situation where you have that many stressed out cats in one place. I resisted the temptation to bring a kitty home, but if you're thinking of adding a cat to your family, please adopt!

Finally, we visited the Dellwood long-term senior care facility in St. Paul. This nursing home follows the Eden Philosophy, which believes that people are meant to be surrounded by living things. Centers that follow the Eden Philosophy try to incorporate animals, plants, and children into the daily life of their residents. At Dellwood, there were 10 cats, 2 dogs, and numerous birds and fish that lived at the center. The cats and dogs are free to roam throughout the building, although each one seemed to have particular people that they liked to stay with or visit on a rotating schedule. The cats were especially mobile, including one who traveled by elevator (he would enter the elevator with someone, peek his head out when it stopped, and if it wasn't the floor he wanted, continue to wait patiently in the elevator until it moved again). The animals helped transform the place from a sterile, hospital-like environment to a much homier living space. The animals helped everyone connect and provided an instant opening for a conversation ("Have you seen Maggie today?" "No, but go check Charlie's closet in room 203, she's usually asleep in his laundry til about 11!"). The animals present a few challenges as far as patient safety, but in the 6 years that the program has been in place, they'd never had a bad patient-animal encounter. I sure hope that I get to be surrounded by critters when I'm 90...

Although the rotation didn't have much to do with caring for patients in the small animal hospital, it was a good way to round out my experiences with food animal medicine. It was also a great refresher for the major zoonotic diseases (rabies!!), and a reminder of how many different roles animals play in our communities.

This rotation marked the midpoint of fourth year. I am 13 rotations and six months away from graduation. I have one month and two days until I take my National Boards, and just under a month until I have to submit my application for an internship. This next month will be a busy one!

Rotation #12: Oncology

2009-11-06T21:42:00.000-06:00

I was fairly certain that Oncology was going to be The Saddest Rotation Ever. Dogs and cats with cancer? All day, every day? Occasionally there are days on Internal Medicine where it seems like all our patients, whether they present for vomiting or difficulty breathing or limping, end up with a diagnosis of cancer. You can tell at the end of the day who had a "cancer day"- they're usually in the Internal Medicine conference room late, typing long discharge instructions and having long sad conversations with pet owners about prognoses and statistics and mean survival times. So, you can see why spending two whole weeks of "cancer days" made me nervous.

But then, I walked into the Oncology Service on day one and was greeted by a small herd of dogs galloping in from the chemotherapy room. During my orientation, a scruffy wirehaired terrier mix kept wedging his head between my knees asking for petting, and a lanky 3-legged lab kept trying to steal peoples' lunches from off the countertops. Oncology felt more like doggy daycare than like a hospital, except that dogs would have to stop their socializing for a few minutes to have a physical exam and blood draw in the morning, then be taken to the chemo room individually in the afternoon for the 20 or 30 minutes that it took to receive their chemotherapy. Go-home time was chaotic, with each dog knowing which leash and collar was his own and going into a wiggle-butt happy dance when they knew it was their turn.

Don't get me wrong, Oncology was not all fun and games. In animals, the goal of chemotherapy (or radiation therapy) is usually not to cure cancer, but to provide palliative care. Often, that means animals go through a course of chemo to get them from a mean survival time of, say, six months to a mean survival time of 12 months. Cancers are very rarely cured, but because we use chemo at much lower doses that in human medicine, animals usually still have a great quality of life throughout their therapy and remission time. Chemo can buy pets another Christmas, another hunting season, or one last trip up to the cabin. But even if the dogs in the chemo room are feeling well and acting like themselves, the inevitable eventually comes. We had four euthanasias during my two week rotation, and they were all more emotional than usual since owners often develop a close bond to the Oncology staff throughout the course of therapy (or even just through the diagnosis of cancer, regardless of whether they chose to pursue therapy).

Cancer makes people feel hopeless and scared, especially if they've had to deal with cancer themselves or with a human family member. Having to deal with the human psychological component of oncology requires a lot of help from Jeannine Moga, the hospital's social worker. She has rounds each week with the oncology department to talk through difficult cases, bad outcomes, or really emotional owners. She also helps out on the hardest cases, like if parents are trying to tell a young child what's happening to the family dog, or if a senior owner's pet has just been diagnosed with cancer and they want to pursue treatment even though they don't have the financial means to do so. Jeannine is a wonderful resource and makes difficult things like the diagnosis of cancer a little bit easier to handle.

So, after two full weeks of cancer days, I have to say that Oncology is not The Saddest Rotation Ever. Somehow, through terrible things like cancer, little rays of hope shine through and pet owners really treasure having that one last Christmas or one last good pain-free week with their friend.

Indianapolis, IN

2009-11-01T05:51:00.002-06:00

Megan is packed and ready to go for her two week rotation in Indianapolis, Indiana. This will be the exotics internship, so hopefully lots of bunnies, birds, and reptiles. And who knows what else! She will return on November 14th.

"Devoured"

2009-10-31T23:03:00.004-05:00

Megan and I saw the Bare Bones Production company put on a spectacular outdoor show tonight, called "Devoured," for Halloween. There is one more showing tomorrow to make up a rained out show, so there is still time to see it. No tickets, just a donation is requested. Here is their webpage.

Here are some photos, and a video. Massive puppets, fire, live music, what else could you want?

Happy Halloween!

2009-10-31T17:17:00.002-05:00

Big Ring Flyers/Green Acres

2009-10-27T07:46:00.006-05:00

Two more races done, and only three more to go this season. Next up is the Crossniac's race which I am involved in hosting, then St. Olaf, then the state championship.

Two weeks ago was the Big Ring Flyers race in Hudson that was well, pleasant. This was my worst race last year, so I wasn't too stoked about it this year. It was the exact same twisty course too, and all on grass, so it was more of a cornering technical exercise than anything else. But, I was doing OK and having a fun battle with a quick little jr rider who I had 15 seconds on, when on the last half of the last lap my chain fell off and I was left in the dust as 5-6 places wizzed by. Oh well, I still finished stronger than last year!

Then this weekend was the awesome Green Acres race, that was a blast of a time. You can see from the slide show below, it started off fogy and a damp 46˚ but dried out a bit as the race went on. Not enough to dry out the mud though! A great asset for me was the large hill that started the race, which I was able to power up and blow past everyone around me. I do like those hills. They could catch up to me on my weak points later on in the lap, but I knew I could hold their wheel and pass them on the hill. The big hill lead to downhill slalom on a tubing hill (fast and fun!), then some wide spaced triple barriers, then off into the wilderness for some mud, grass, single track, more barriers, and high entry-speed sand traps that could take you down if you were not careful. I lost my back wheel on the rocky single track and bit my pedal into the hill and went down on the last lap, which lost me a spot. But I was still happy with my finish, which was in the 53 percentile, and a new record for me. My season goal of sub 50% seems to be getting closer...

Here is a slide show, with the first half taken by Megan and then some shots of fellow Crossniacs doing there thing, taken by me. Taken with our new Canon D7 camera, but that is another blog post..

Rotations #8, #9, #10, and #11

2009-10-15T22:38:00.002-05:00

My, how time flies when you're getting married! I've fallen far behind in my rotation recaps. Hopefully this post will make up for it....

Rotation #8: SAM-B

Students on the small animal track take four rotations in Small Animal Medicine (SAM). The first SAM (SAM-A) is a chance for us to get oriented and learn the basics of how to approach a medicine case. Clinicians will usually ask us what we think the animal's problem is and how we would proceed with diagnostics and treatment, but they generally lead us along through our first cases. The next three SAMs (SAM-B's) are progressively more hands-off by our clinicians. We're expected to make more decisions about which diagnostic tests to run, which specific drugs and doses to use, and how to manage hospitalized patients. Obviously they'd never let us decide to run a test that would be a waste of money, or use a drug that isn't indicated, but the goal is to make us feel more like the primary doctor on the case rather than just an assistant. We're also expected to know more about pathophysiology (the reasons why a disease affects the body the way it does) and spend more time looking into current literature about diseases and treatments.

Thankfully, even though there are higher expectations, my first SAM-B felt easier than SAM-A. I think it was mainly because I didn't need to spend as much time figuring out logistics (like how to submit a blood sample), so I had more time to research each case. I also got more efficient at taking a history and doing a physical exam, which also helped to streamline things. My cases were in general less intensive than the patients I saw on SAM-A- I saw a lot more patients who were being managed for long-term diseases, like diabetes and hyperthyroidism, and fewer infectious diseases like blastomycosis or leptospirosis. It was a good rotation for working on my basic clinical skills and building a little confidence.

Rotation #9: Vacation!

My 9th rotation block was my second of two vacation blocks. We got married (yay!) and relaxed up in the Boundary Waters. My last break will be in late October, when I get a week off (since our Public Health rotation is only one week long)... then it'll be straight through until graduation. Yikes!

Rotation #10: Anesthesia

I've gotten a nice gradual introduction to anesthesia, starting with being the anesthetist for one dog in sophomore surgery lab, then for six dogs and cats in ESAS. The difference between those experiences and the anesthesia rotation is that my previous patients have all been relatively young and healthy. Under the supervision of our anesthesiologists, our rotation was all about getting comfortable with anesthesia of less-than-healthy animals- for me, it included a geriatric cat in renal failure and a ruptured eye, a dog with a large bleeding tumor on his tongue, and a cat with a heart murmur and several fractured teeth. For the first time, I had to handle situations like low blood pressure, slow heart rate, fast heart rate, waking up on the table (not during surgery, thank goodness!!), and monitoring a patient who's inside a CT machine (where you have to be across the room instead of right next to them).

Also, unlike our other anesthesia experiences, we got access to all sorts of fancy equipment- things like mechanical ventilators, end-tidal CO2 monitors, EKGs, and blood pressure monitors. We were also encouraged to try out anesthestic drugs and protocols that we'd never had experience with, so that we could get comfortable with how each drug and combination affects a patient. Our anesthesiologist is famous for letting us experiment, even if we choose drugs or doses that she knows won't be particularly effective (never putting the patient at risk of course- just leaving them awake enough to lead to phrases like "And then I removed the cat from her face.")... since we learn more from our mistakes than from being corrected. She'd never let us flounder, but she didn't mind watching us sweat a little while we tried to troubleshoot monitors, drugs, or catheters. Anesthesia was easily one of the most valuable rotations I've had yet!

Rotation #11: Ophthalmology

Eyeballs. Aside from derm, I can't think of any specialty that makes people go "Ewwww" more often. It's understandable, considering ophthalmologists have to deal with things like melting corneal ulcers or proptosed eyeballs (warning: links for the non-squeemish only!). But, it's hard to ignore the draw of a specialty that gets to bring eyesight back to animals blinded by cataracts. Most of what we did as students on the ophtho rotation were routine eye diagnostic tests, like measuring tear production or testing the pressure within the eye. We also learned how to do a proper fundic exam, which is an important skill for any general practitioner.

The best days, though, were the surgery days. We got to see our ophthalmologists perform goniovalve implants, which is one of the same procedures done to treat glaucoma in humans. Glaucoma occurs when the fluid produced inside the eye isn't able to drain out normally. The pressure in the eye increases, eventually causing pain and making the eye to go blind (remember Kirby Puckett?). A goniovalve is an implant that looks a little like a computer mouse. The "tail" is a tube that goes into the front chamber of the eye, and the "mouse" is a hole-filled plate that attaches outside the eyeball and allows the fluid from the front part of the eye to drain. It's not a permanent fix, since eventually it gets plugged with cells and protein, but it can buy months of pain relief and sight for an animal with glaucoma.

We also got to see a lip-to-lid resection, a form of plastic surgery for a dog with a tumor on one of his upper eyelids. The lid was removed and replaced with tissue from his upper lip (hence the name lip-to-lid). The lip tissue wasn't able to be attached to the muscles that normally make the eyelid blink, so the dog ended up with a bit of a droopy lid- but the alternative was removing the tumor, eyelid, and eye, so a droopy lid is a small price to pay.

Ophtho was a little light in the hands-on sort of learning, but a fun rotation to see what's possible for animals with eye disease. I still think eyeballs are kind of gross, though... ;)

Tomorrow is my last day of Oncology... hopefully I'll stay caught up on my rotation reviews!

Wirth CX

2009-10-12T07:55:00.013-05:00

It was another crazy and a little frustrating race at Wirth this year. They removed the single track mountain bike stuff that I didn't care for last year, and replaced it with a quick downhill to the lake, followed by a massive stair climb up. It would have been a better course if there were fewer people! I started in the middle of the pack (or heard in this case) and felt well going through the first log barrier, but then things slowed way down heading down to the lake and came to a stand still at the steps. Apparently it takes a looong time for 115 riders to clamber up a steep set of uneven stairs, and it made a traffic jam. So I ended up walking up the stairs slowly with the person in front of me bopping me on the head with their rear tire the whole way. Not very dignified at all. This kind of jam kept up for about four laps too.

Worse, they had informed us they would be pulling (removing) riders if you get lapped, making the long wait at the stairs and every other rough bit even more bothersome.

But, the course opened up and I got a kind of rhythm going and was nearing the final lap with out getting lapped, until about 50 yards in front of the line I get passed by the leader, thus I was the ~~first~~ last rider cut. Needless to say, that did not make me happy as I still had lots of legs left. So boo on the course designers for designing what must have been a great A course, but a awful C traffic jam.

Lots of great photos though! I love my new Crossniac's kit, it looks and rides great.

Oh and I finished at the 60th percentile, which is still a big improvement from 74th last year.

Crated dogs beware

2009-10-09T06:38:00.002-05:00

Wow, how's this for a weird headline:

Dog stuck in crate highlights rare risk of spot-on flea treatment

Apparently Advantage flea/tick spot-on products contain benzyl alcohol, which can react with plastics and dissolve them (and, in some cases, glue a poor dog to the floor of his crate!). Make sure your spot-on flea products are nice and dry before you leave your dog unattended.

2012

2009-10-08T08:21:00.003-05:00

The disaster porn movie, 2012, about a Mayan predicted apocalypse looks awful. But, this re-cut of the trailer makes it look awesome. I am now torn.

If you are curious, here is the original.

Rotation updates, etc

2009-10-07T06:32:00.004-05:00

I've gotten far behind in my rotation recaps, but I promise I have a post waiting in the wings that's nearly finished! Until then, a quick reminder that this coming weekend is the College of Veterinary Medicine Open House (Sunday, October 11th, 11 AM to 4 PM). It's always been held in the spring in the past, but they moved it this year to coincide with Homecoming Week. It's great fun- you can tour the hospital, Equine Center, and Raptor Center, see talks about getting into vet school, hear a lecture from Dr. Pluhar about the famous Batman, and see demos of canine and rabbit agility!

Yes, I said rabbit agility...

You can see the full schedule here. Hope to see you there!

Orono seat cam

2009-10-06T07:28:00.001-05:00

Check out MN Crossniac Mike C's sweet seat post cam of the B race at Orono on Sunday. Way better than me describing it!

Planet Bike - Orono CX

2009-10-04T20:25:00.006-05:00

My first Cyclocross race of the year is in the bag! I finished 37th out of 66 riders, which percentile wise is my best finish ever! It was also my first race as an official and proud member of the Crossniacs team, complete with my sweet new black and blue kit with the Crossniacs lion on it.

It was a fantastic course, really a CX exhibition course. You started on a nice wide gravel loop, then fast down a twisting grass shoot, then onto blacktop, then through a sand pit, then double barriers, then really uneven and off camber grass, then a straight sprint through grass and dirt, followed by another twisty grass bit and capped off with a barrier at the base of a hill that required a nice run up after.

That pretty much sums up what Cyclocross is! The only thing missing was mud/snow. They also kept the course nice and wide open, with no sections that could be really be called single track, which I liked.

As for my race, I really used my new tires to their full advantage and bit in hard. I started a bit back in the pack, so I had fun clawing my way up the ranks as the race wore on. It was painful, but the course rolled so nice and was so open I was able to build a very nice rhythm that served me well. The race ended with one extra loop around the starting gravel loop (around a soccer field) and I was totally burnt up, but then I heard L. shouting at me followed by crunching gravel in my ear. So I floored it again. I managed to pass one rider in red that I didn't think I could have caught before the rider chasing me cut me off real close on the final turn and was gone. Oh well, gain one loose one! I learned something about tactics too I think. I just about died after the finish line though, that last sprint was killer.

Self Sufficiency

2009-10-04T20:08:00.006-05:00

Doing things yourself can be very difficult, full of mistakes, and extremely time consuming but when things go right, it is sure worth it. Having another item in a library of things you can do feels great. ( Can you tell I have been reading "Zen and the Art of Motorcycle Maintenance"?)

Our first project was on Wednesday when Megan and I canned salsa, using our piles of tomatoes from the farmers market. Of course now that it is preserved we are hesitant to open one since it is so much work getting them in the jars!

My other project was on Saturday when I finally got some car time in. I cleaned my air filter, replaced the oil (synthetic is totally worth it), and replaced the front brake pads. All this greatly increased my confidence for car repair again, as it was all quite simple, and the car really needed it. The brakes just required me to jack up the car and remove the wheel, un-do one bolt and swing up the "glove" that holds them next to the pistons, and then pop out the old pads like burnt toast. With the money I saved I bought myself my very own 2 ton jack!

Grandpa

2009-09-23T21:34:00.005-05:00

Thanks to everyone who has called/emailed/texted me today. My Grandpa Clarence W. Strandberg passed away quickly early this morning at the age of 90 after a two week illness. It was certainly his time to go, but of course it still comes as a shock to the rest of us. The funeral will be on Monday morning at 11:00 in New Richmond, and he will be buried at 2:00 at the Hill Side cemetery in Minneapolis. For more information on arrangements, click here.

I will write more later, but it makes me so happy that he was able to be fully present at our wedding just 26 days ago. I know in my heart he was holding on for it, and had a wonderful time with all the family that was present.

His official portrait for this week.

Riding around in my "New" Volvo with Grandpa

One of my favorite portraits of him.

Grinding apples

2009-09-18T15:50:00.003-05:00

Last night D. and I ground up about 50 lbs of apples to produce about 3 gallons of cider. These are very dry, very rich apples!

We then used that cider in a 5 gallon batch of beer that uses roasted barley, toasted oak chips, and French Saison yeast to hopefully make a nice smoky apple beer.

But the fun part is grinding the apples using my garbage disposal method. It chews up the apples in a few seconds and spits out applesauce perfect for pressing. I recorded some video, take a look!

Megan's first publication

2009-09-17T17:33:00.004-05:00

A huge congratulations to Megan for being published in the Summer 2009 newsletter for the Society for Vetranary Medical Ethics, or SVME. The issue is 12 pages long, including the address label, and Megan's essay takes up 4 pages of that! I will post a link to the PDF when it is online, but for now here are some photos of the newsletter we got in the mail today.

Fall food abundance

2009-09-16T23:36:00.005-05:00

This fall I have decided to really ratchet up our farmers market buying, since if you can handle the volume the cost hardly increases. For example, to buy 4-5 nice tomatoes costs $3 now. But for $10, you can buy half a peck of tomatoes, which is a completely full shopping bag worth of them. Hundreds! So I bought a 1/2 peck and tonight blanched off all their skins, cut them in half, and froze them in freezer bags. I also made a large pot of fresh tomato sauce that I will freeze as well. Megan also mentioned canning, which would be the ultimate in farmers market preservation. It still scares me somehow, but I would love to try.

The second fun event is Megan's parent's apple tree had another bumper year this year, after taking last year off. Last weekend we went and picked two large boxes full, with 5 times as many still on the tree. Tomorrow D. and I are going to crush and press the apples to make a cider, that we plan on using in our next beer in place of most of the water. There will be lots of cider making this fall I hope!

Finally to make our 19th century lifestyle complete, Megan made a watermelon rind pie in honor of my Grandma's fabulous watermelon rind pickles. It is fantastic, with a very fall-like combination of nuts, spices, and raisins.

Enjoy the slideshow!

Mr. and Mrs.

2009-09-01T07:23:00.004-05:00

We did it! Many many more photos to come, but for now we're off to the Boundary Waters. Be back in a week!

A thread

2009-08-12T14:08:00.005-05:00

I got back from the farmers market yesterday to find that my trailer attachment was being held on by 4 metal threads. The braided wire I had used stretched out, and once it got long enough the PVC tubing was able to rub right through it. It chewed through 4/5 wires completely, and then ate through most of the remaining one.

Back to the drawing board for this design!

So you suck at mountain biking...

2009-08-09T21:44:00.002-05:00

Well its not so bad. But my first foray into mountain biking was not the most graceful thing I have ever done. I crashed a lot. I hit a tree with my handle bars, I lost control on a turn and landed sideways in the bushes, I did a big crash after I lost control on a sand bar that almost sent me rolling all the way down buck hill, and skidded out on another corner. But I did get this cool picture of me looking determined!

Worst of all though, I got a dreaded DNF (did not finish) when it was just too much. I was too banged up, and too tired to properly control the bike and I figured I could either end now or end in a crash some place else. So I rolled off. It also turned out my front tire was flat, but we didn't see that until we got home.

So, here is looking towards the Cyclocross season which starts in September when I will have the chance redeem myself as a competitive bike rider!

Rotation #7: Dermatology

2009-08-06T06:38:00.005-05:00

Dermatology is portrayed in Grey's Anatomy as a magical place where the doctors are calm and relaxed, they serve water filled with floating fruit, and everyone is dressed in pastels. Dermatologists work 9 to 5, no weekends, no on-call duty, and as they say, "there are no dermatologic emergencies."

My experience on the veterinary dermatology service hasn't involved any fruit-filled water, but it has been a nice change of pace from Small Animal Medicine. The biggest difference is that we don't have any hospitalized patients, so we get to focus only on the clients coming in for appointments. We also see a lot of long-term patients and spend a lot more time on client education than some other services, since animals with skin disease can require fairly intensive management to keep their diseases under control.

Derm is a huge part of veterinary medicine (Dolittler puts skin diseases as her #1 and #2 most common types of appointments), so it's been good to get my feet wet working with some of the most common types of skin problems. We've seen food allergies, environmental allergies (aka atopic dermatitis), sarcoptic mange, demodectic mange, endocrine disorders like hypothyroidism, autoimmune diseases like onychodystrophy (where the body attacks the nails) and sebaceous adenitits (where the body attacks the sebaceous glands of the skin), and some unusual diseases like Daschund Pattern Baldness.

Despite the economy, the Dermatology Service is still booked out for over a month in advance. I don't mean to sound cynical, but I suspect the reason that people are so willing to treat their pets' skin diseases is because they are embarassing (dogs with inflammed skin or hair loss are very noticeable on walks or at the dog park) and annoying (the constant licking, chewing, biting, and scratching of an itchy dog can wake owners up at night and drive them crazy during the day). It's relatively easy to ignore a limp, brush off those little lumps and bumps, or think that drinking more or eating less are just signs of old age.

Nonetheless, I think it's wonderful to see owners that are willing to devote all the time, money, and energy that it takes to manage what are often lifelong diseases. The differences that a dermatologist can make in an animal's quality of life can take a long time, but they can be dramatic. For example...

Treatment of generalized demodectic mange can turn a dog from this:
into this:
I don't think I'd ever specialize in dermatology, but it's nice to have a better idea of how to diagnose and manage the most common conditions I'll be likely to see in practice.

Next up is another Small Animal Medicine, then the wedding!

Toy Camera app

2009-08-03T14:18:00.003-05:00

So the camera on the iPhone is pretty good, but is not the best. You can tell it is a cell phone camera and the photos can often look a little dead. So I bought app for the iPhone called "Toy Camera" by Japanese developer Takayuki Fukatsu for fun. All it does, which I usually can't stand, is apply some photo filters to the picture you just took to make it look like it was taken on a cheap toy camera of various types and with various films. The thing is, it seems to really make the photos better! There are a few reasons for this I think, primarily because that it adds a film grain which hides some of the typical (and ugly) digital blur caused by tinny cellphone lenses and sensors. I like the more subtle color modifications, like low saturation, which act to warm up the often flat default shots. But the more extreme ones like high contrast black and white are fun too.

All this made me wonder though, in 40 years will there be a "cell phone" filter to make your crisp photos look like they were taken on an early iPhone? Ah nostalgia...

31 days

2009-07-29T21:27:00.004-05:00

31 days. One month. Lots to do!

www.ChrisandMegansWedding.com
WinnieLovesWeddings.blogspot.com

To market

2009-07-28T08:39:00.004-05:00

To the farmers market, on the bike, with a bike trailer. That earns me some pinko Amsterdam points for sure.

With a load the trailer still rides great. You have to get used to the odd things it does to momentum, like when you are cruising on flat you just keep going, but going up hills is much harder. Object in motion, gravity, and all of that. But I can still speed if I need to, and it doesn't affect the handling of the bike otherwise.

Trailer part 2

2009-07-27T18:01:00.005-05:00

My test trip with the trailer taught me a few things, that I corrected today. The wheels couldn't come off, the bolts that hold the wheel attachment on still get stuck on doors and corners, and there was also no spot to attach bungees. I solved the first problem with a long piece of scrap copper that I cut and screwed into the frame, and then ground down the screw heads so they were flush. I then took a radial sander to the copper to smooth it out, and ended up sanding the entire frame! It looks better than new now, and I coated it with spray sealer to keep it that way. I removed some wood from by the wheels and now there is space for them to come off, and I drilled some holes in the bed to attach my bungees.

The whole thing rolls great! The connector is smooth and can bend more than the bike can turn. I am looking forward to a nice big grocery run.

Rotation #6: SAM-A

2009-07-26T08:30:00.009-05:00

My last rotation block was actually a vacation (which we still need to blog about too!). We spent half of it up north, and half out in Seattle. I got to attend two days of the AVMA national convention, which was gigantic and awesome and a little overwhelming. We got back Sunday night at midnight, and at 8 AM Monday morning, I was at school for my first day of Small Animal Medicine (SAM). Small animal track students have to take four rotation blocks in SAM. The first one is called SAM-A, where they give us a little more leeway in terms of how efficient we are, how thoroughly we take histories and physical exams, and how well we know our way around the hospital. The other three are called SAM-B, and the standards are higher for SAM-B students.

The Internal Medicine and the Surgery services see the bulk of patients that come into the teaching hospital. In a nutshell, if an animal's problem can be fixed surgically, it goes to see the Surgery department. If it's a nonsurgical issue that doesn't fit into some other specialty (like Cardiology, Dermatology, or Ophthalmology), it goes to the Internal Medicine department. Over the past two weeks, I worked with patients who had:

-Anaplasmosis, a tick-borne disease that infects white blood cells. The hallmarks of anaplasmosis are low platelets and a really high fever. These dogs can come in really sick and need hospitalization, but thankfully the treatment is a widely available, inexpensive antibiotic. Lots of people know that ticks carry Lyme disease, but Anaplasma is another nasty disease that can be prevented with good tick control (i.e. topical spot-on products like Frontline).

-Leptospirosis, a bacterium that is spread through urine. Most dogs get exposed by drinking water contaminated by wildlife that were infected with lepto. Lepto causes liver disease and renal failure. Dogs who make it through the initial infection but are never treated can become lifelong carriers and shedders of lepto. Lepto is a zoonotic disease (you can catch it from your pet), so careful handling and thorough treatment are important.

-Blastomycosis, a fungal disease endemic to Minnesota, Wisconsin, and the Mississippi and Ohio River Valleys. Both humans and dogs can be infected with Blasto, but dogs are about ten times more likely than humans to get infected (likely because the spores are in the soil, and dogs are about ten times more likely than humans to be snuffling around in the dirt). Blasto can infect the lungs, skin, bones, joints, eyes, brain, and just about anything else in the body. Many dogs diagnosed with blasto don't survive long enough to make it out of the hospital. Of those that do, their owners have to be willing to take on a long-term committment to very expensive therapy with an anti-fungal called itraconazole. For a large dog, itraconazole can cost $400-$500 a month, and therapy can last over a year. Blasto is evil.

-a puppy with more congential defects than I've ever seen in one animal. She had open fontanelles (her skull never closed completely), hydrocephalus (excess fluid in the brain), retained baby teeth, luxating patellas (the kneecaps slip out of place), and congenital hypothyroidism. About the only thing she didn't have was a heart murmur. There is no way to fix most of her problems. It was a good reminder that, no matter how cute that puppy in the window is, please don't buy a pet store puppy.

-diarrhea and vomiting. These two problems are truely the bread-and-butter of veterinary medicine, partly because they are uncomfortable for the pet but mostly because they are really inconvenient for pet owners. The list of what can cause diarrhea and vomiting is ridiculously wrong, from something as benign as eating a bag of potato chips to more serious problems like Exocrine Pancreatic Insufficiency or a Inflammatory Bowel Disease.

-cancer. I saw lots and lots of cancer. Dogs and cats can get all the same types of cancers that we can get (including those associated with smoking, if they live in a house with an owner who smokes). Often, cancer in pets starts with really non-specific signs like diarrhea or weight loss, so they come to see the Internal Medicine service. Oftentimes, an abdominal ultrasound is all we need to do to find a large mass somewhere in the abdomen. Some owners opt for more thorough imaging like a CT scan or MRI. If an animal has a single mass, we might send them over to surgery to have it removed. If there are multiple masses or if the mass is in a location where it can't be surgically removed, they visit with the oncology department to talk about options such as chemotherapy or radiation therapy. In animals, our goal with cancer treatment is never complete remission as it is in humans. The goal in veterinary oncology is to prolong quality of life rather than to extend quantity of life, so we generally use lower doses of chemotherapeutic drugs than is used for humans. Humane euthanasia is also often a very kind and reasonable choice for an animal with cancer.

All in all, SAM-A was a challenging but educational rotation. There were a lot of sad diagnoses, but less euthanasia and more happy endings than I saw in my emergency and critical care rotation. Next up, Dermatology!

Bike Trailer

2009-07-25T13:25:00.006-05:00

I was walking Winnie and over behind the security alarm building, and there is this little section of scrub that people just dump their typical urban junk in. There is a refrigerator, a car tire, a shopping cart, and a few days ago there was a torn up InStep Quick-n-Lite bike trailer. The same kind we bought last summer for winnie, which was fun but she kind of hated it. So I dragged the trashed one home, sold Winnie's for $40 (same price as we bought it) on craigslist, and started to convert the busted one to a bike trailer by ripping off all the fabric and coverage parts.

It was missing its bike attachment part, so I towed it to work by wrapping the end with an old bike inner-tube and attaching that to the back which was good enough (barley, and it somehow managed to flip completely over at one point). Then I took off the wheel attachments and inverted them so the wheels would be inside the frame, which makes the entire thing more narrow and easier to maneuver. Also this way, the wheels are protected should the trailer strike anything. I then cut down some aluminum rods to lay down down the center so it can support weight. These I attached with bolts. To make the connector, I used a quick release attachment normally used for pressurized air, that just happened to screw into the soft aluminum at the end of the connector arm. The piece on the bike is a small drilled steel plate, with an eye-hook bolted onto it, that is attached to a piece of PCV pipe with steel rope, that is attached to the quick connector. I might have to re-do this part, because it is kind of huge! But it works great, so I can't complain.

And here is the finished product! Now I have to figure out how to attach a load on it, like groceries, and also figure out what to use it for! I also have to make the clearance between the wheels and the trailer bed wider, so I can remove the wheels.

Palin Circus

2009-07-07T10:26:00.002-05:00

I could have much to say about the latest Sarah Palin circus, but really it has all been said about 1000 times by now so why bother. But don't let anyone tell you that resigning from the Governor's office is a shrewd, calculated, or brilliant move. It was dumb, amateurish, and petty which pretty much sums up Palin's political career so far. And I think this is the end of that short political career. Her best bet now is to use her fame to re-make herself as a kind of Alaskan Glen Beck or other conservative personality.

If there is some pity for her absurd situation, I would say that she never asked to be in this position. Rather it was the Republican strategist's (and John McCain's) desire for another super star, another Ronald Reagan, that pulled her into the spotlight. She seemed to have the rough outline in place so they could just fill in the colors however they wanted. That of course, did not work and the experience seems to have made her far more fragile, and paranoid, than ever before.

But I wanted to leave with this beauty of a quote from her, during a recent ABC interview about those frivolous ethics charges that never the less managed to drive her out of office after just two years, and why the office of Vice-President (or President) would be different. Go ahead and unpack this piece of Palin Zen for yourself:

"I think on a national level your department of law there in the White House would look at some of the things that we've been charged with and automatically throw them out," she said.

There is no "Department of Law" at the White House.

iPhone 3Gs

2009-06-25T12:23:00.009-05:00

So I did it, I got the iPhone. I have been waiting for the 3Gs to come out for a few months, and was on a pre-pay plan during that time, which was kind of strange and slightly limited my feeling of connectivity with the rest of the world. I was still unsure about getting the iPhone almost up until the day I got it. It is an extra $30 a month for data after all, and at $200 for the device itself that is getting expensive.

But I have had it for three days now, and I can see that is going to be easily worth it. I was expecting it to be good, so I am surprised that I am as impressed as I am. It is very fast, acting on most requests instantly. I did not expect that the phone would be better than a normal computer in many respects. For example, looking up things on Google maps feels great on the iPhone. By hitting the little target icon on google maps, it zooms into where you are. Tap it again and it shows you what direction the phone is pointing (and you too if you are holding it). Then to get directions, you either drop a pin icon where you want to go or enter in an address and it draws it for either car, public transit, or walking. It does it all of this as fast or faster than my laptop, with multi-touch flicking you around the map, and all over the 3G connection. Throw in search, and all the free apps that augment google maps, I should never be lost again!

I also was not expecting the GPS to be as functional as it is. I tested it on my ride to work today, and got this map, a little obnoxiously branded with their name, "MotionX GPS." Note that I just stick it in my pocket after hitting "start" and didn't let it sync to the satellites well enough at first, so the elevation is all off for the first .2 miles. I also stopped 1/2 way to try another (inferior) GPS app.

View Larger Map

Then you can take the data and plug it into lots of different web pages. I use MapMyRide.com to record bike rides, and it displays there just fine. They have an app that uploads directly to their site, but is doesn't capture or show enough data for me. This is another good one, that graphs everything out very cleanly. But my favorite is this one that does a little animation of you riding, so you can see how fast you were going along the way:

Update, I stuck a better trip in here so you can see how it works better

Home from work July 25th 2009

Or click here to see it full size.

I am happy with the camera, but cameras can always be better. Sometimes the photos are blurry and there is no zoom. Here is a sample photo I took of the camera at its best. Winnie was not impressed.

I am very happy with the video, which is quite nice. Here is a video I took showing the loading doc of the Macalester Art Department and the foundry during its summer re-set. I uploaded it to YouTube right from the phone. (Hit HQ for better quality)

The new iPhone software now "pushes" data to the phone, meaning that you don't have to go check a server for new data, it finds you and sends it to your phone immediately. So far, only AOL instant messenger and a free text message software called "TextFree" use it for no charge (SMS users, ask me for my address so I don't have to pay $.20 pr text). I hope gmail can figure out how to use it soon. Right now it automatically checks for you every 15 min, which is good, but push takes seconds.

Thats all for now. The feeling of being totally connected all the time is a little strange and addictive, but I am enjoying it!

Re: Dr Sophia yin on dog training

2009-06-25T08:26:00.011-05:00

(note: the photo is Winnie before we took her home when she was super naughty and fluffy!) Not to put a point on disliking Cesar Millan, but one of our neighbors just walked by with her poor pit-bull mix doing full "dominance" training - that had just devolved into obvious physical abuse. I heard the dog crying and yelping about every 5 seconds from outside. It sounded like a broken car, but I looked out to see her taking about 5 steps with the dog on a super short leash, and when he would walk a bit forward (not healing I guess) she would yank on the leash as hard as she could which would often pull the dog up on two legs, yell at it "NO," and sometimes grab the dogs neck in a Cesar style "bite", causing the dog to scream. She had treat bag on her hip, but that was ignored. This continued the whole block, until they got to the grass and he went to the bathroom. The poor dog obviously had no idea what was wrong, what he was supposed to do, was extremely agitated and terrified.

Now Cesar Millan does not endorse that kind of training, he would say, and you can't account for everyone. But when you start off from the point where your main source of coercion is physical control of the animal, these are the kind of results you see in the public. I could tell that this woman was frustrated, and embarrassed by her pet because he was not being "perfect," and barks at other dogs. As a dog owner, I know that it can feel like a reflection on yourself when your dog does something embarrassing. So when Cesar says that these actions are an attempt to control/dominate you, that makes them both embarrassing and insulting, and anger is the immediate reaction. The absolute easiest thing to do is to then, is yank on the leash because you do get to control the animal in an immediate and visceral sense. And often you get your way quick, which feels good when you are angry, and you show other people you are taking action as well. And when people watch Cesar's TV shows and get the idea that not only is it the easiest thing do do, it is the right thing too! I believe this leads directly to what I saw outside. An angry woman, applying more and more physical pressure to an increasingly confused and frightened animal. Rather than teaching her pet to be good, she has the perfect training regime to make an animal fearful of her, other people, other dogs, kids, outside, or whatever. And when it is a dog a powerful as hers that is extremely dangerous.

But even for situations that are not nearly extreme as the woman outside, it is just not fun to be angry at your dog. Sometimes Winnie will refuse to go onto a patch of grass because it is wet, and she doesn't like the feeling. So she plants her feet and tries to pop out of her collar - which has worked once or twice! Sometimes I am in a hurry and perhaps in a bad mood, so I just simply drag her on because I can. She looks miserable, and I get more annoyed, and we both end up unhappy. Or when I am doing it the right way, I pretend like there is something really good on the grass, like bunnies or a stick. Now her attention is on that, and not the icky grass, and she goes running onto the grass and we play. She has fun, I have fun, and we both end up happy. The physical results are the same (she is on the grass) but with just physical control she is more unlikely to listen to me in the future, while when it is all a big game she wants to because it is fun.

By limiting dog behavior to basically "dominant" and "not-dominant" Cesar limits the reactions from dog owners to their dogs drastically. Far far more often than not, they are being motivated by something else that is perfectly dog-like and reasonable, just at the wrong time and place. But understanding those motivations can be difficult, and using rewards and games takes more time and effort than punishment and physical control. So in that sense, Cesar is a perfect product of what we all want to hear. Training your dog is easy, you just have to be in control. You have the leash after all.

ESAS, week two

2009-06-24T22:15:00.008-05:00

More creatures from ESAS... Does anyone need a sweet dog or cat?

Scrappy the border collie/Australian shepherd mix:
Nipper the 14 week old sheltie mix:Gunther the German shepherd:David the kitten:Soapy the tomcat:Precious the tabby cat:Li'l Tree the grumpy kitten:

More ESAS

2009-06-19T18:22:00.013-05:00

I successfully neutered one cat, spayed two kittens, and neutered Bucky (my parents' new dog) this week. Three (or four?) more surgeries next week, and then a much-needed vacation block. Phew!

More critters from ESAS...

Chica post-spay and rear dewclaw removal:

Toes the polydactyl tuxedo kitten:

Annie:
Luna (a.k.a. Lunatic and Looney Bin)- a bit of a wild child:

Max the lab/hound puppy:
A very unhappy, still slightly drugged Flip Flop the kitten:
Bucky the Shiba Inu, who was actually recovering from surgery, and Winnie, who was pretending to be recovering from surgery too:

Wet

2009-06-16T19:08:00.002-05:00

I dusted off the old time-lapse controler, put in a new battery and it still works just as well. I have work on remembering a few things though.

Here is our wet street, over the course of about 30 minutes.

Rotation #4: Elective Small Animal Surgery

2009-06-15T21:48:00.006-05:00

I promised this one would be more exciting! I started Elective Small Animal Surgery (ESAS) today, which means I'll be performing around 6 surgical procedures over the next two weeks. Hopefully I'll get to do a cat and dog spay, and a cat and dog neuter, plus maybe some other types of surgeries depending on the needs of the animals (i.e. dental cleanings, mass removals, etc). All of the critters that we'll work on come from local shelters and rescue groups. Here are our animals that will go under the knife tomorrow...

Chica the chihuahua, who is just as nervous as this photo makes her look:

Jackie the 9 week old calico kitten:

Tiger the tomcat (my surgery!):

There will be three new animals every day- I'll try to remember to post pictures of everyone!

Rotation #3: Lab Medicine

2009-06-15T21:12:00.004-05:00

My third rotation put me back in the classroom for Lab Medicine. No, not those kinds of labs...

Lab medicine (or clinical pathology) is the practice of interpreting bloodwork, looking at blood smears, examining cells from masses, growing bacteria from infected tissue, and anything else that you could think to measure in the lab. The clinical pathologists do some of the same work at the anatomic pathologists (the people who perform necropsies in the Diagnostic Lab), except that they generally work with samples from animals who are still alive. The rotation itself was good, but it wasn't much different from being in class like I've done for the past three years.

Stay tuned for an update from my latest (and more exciting) rotation...

Dr Sophia yin on dog training

2009-06-11T21:47:00.003-05:00

Specifically on dominance, and the often dangerous and and outdated beliefs of Cesar Millan, who Megan has written about before. You can read the entire thing here, along with all the included videos. Even reading one part of it is worth it!

Lets just compare these two examples of small, fearful dogs. Who would you rather have training your dog? The one that gets bit or the one who turns it into one big game?

Rotation #2, week two: Emergency

2009-06-01T22:22:00.004-05:00

I finished up rotation block #2 last night with my final night in the ER. Over the past week, I saw:

a dog who ate four pizzas, a carcass of some sort, and a bunch of rib bones stolen out of the garbage
three dogs with pericardial effusion
a puppy who ate a sock
a dog who ate a several socks and a pair of nylons
a dog who choked on grass
a dog with fluid around his lungs and in his abdomen (probably secondary to cancer)
a puppy with an infected tick bite
a dog who bled into his eye after being accidentally hit with a ball during a game of fetch
a chihuahua who ate half a bag of Dove chocolates
a cat who had a blood clot in his aorta (a.k.a. "saddle thrombus")
three cats in a single night who were all having problems breathing secondary to heart disease
a cat that was hit by a car
a dog who ingested rat poison
a dog who ate xylitol-containing gum
a dog who couldn't close his eyes due to facial nerve paralysis
an anemic cat
four dogs with hindlimb weakness or paralysis due to intervertebral disc disease (almost all dachshunds)

I also took what felt like a hundred histories from owners, performed a lot of physical exams, placed two IV catheters, and performed my first thoracocentesis (chest tap). The rotation was feast or famine, either crazy busy or totally dead. I learned a ton, but faced a lot more sadness and death than I was prepared for. I'm not sure if emergency medicine is for me... but it is a wonderful resource to have available in our community.

I'm on to Lab Medicine now, which is two solid weeks of practicing looking at blood smears, interpreting bloodwork and fluid analysis, and looking at samples of various tissues (i.e. bone marrow biopsies, fine needle aspirates, impression smears, etc). So, back in the classroom. Time goes a lot slower outside of the hospital, but it's nice to have a little break from patients.

Rhubarb pie

2009-05-29T23:08:00.003-05:00

I'm not the only one who is making pretty looking food things. This morning Megan made this fantastic Rhubarb pie with ginger. Tart, sweet, and a a little spicy. Yum! I ate 1/4th of it after dinner..

But before that, it deserved some table-photo treatment!

Tea Beer

2009-05-28T19:31:00.003-05:00

I wanted to share the latest beer to come out of the brew pot. This is a beer that D. and I have been talking about for what might be years, but by the time we got to make it he had moved out of the state! Megan and I are going to visit in July (thanks in part to the previous post) so I can still bring a few to share out there, which is good because I think it is the very best thing we have ever brewed. The main feature was 2 oz of jasmine tea from the Tea Source in St. Paul that was included in the process at several points. I believe that some of the natural yeas that is on the tea got into the beer, giving it a fantastic sour tinge reminiscent of a lambic. That could just be from the Bravarian yeast though. The tea it self provides a wonderful floral backdrop and a dryness that does not normally appear in a beer. Beer is usually bitter, but this contains the plesent astringent quality of green tea.

You can bet this is going into the State Fair this year!

Here is the recipe, for the record:

1 lbs crushed carapils malt for body, foam
3.15 lbs Wheat Malt extract
3.15 lbs Pilzen Extract
.5 lbs light DME

Saaz hops (1 oz @ 3.6 a)

Jasmine tea (2 oz)
Sencha
lavender
heather tips

WYeast - Bravarian wheat

#1 Steep grains at 65-70˚ C for 30 min, remove and sparge
#2 Steep 1 oz tea mix (60% jasime, 40% sencha) while temperature is rising. 70˚ C -> 90º C. Remove and add malts.
# 3 Boil 1 oz saaz for 60 min, chill.
# 4 Brew 1 gallon of strong jasmine tea. Adjuncted with heather tips, and lavender (couldn't help my self. I need to keep the floral lavender/jasmine flavor there!) .6 oz lavender, .4 oz sencha, .1 oz lavender, .3 oz heather tips. Brew for 10 min. Remove tea, then boil briefly.
# 5 mix in boiling tea to chilled wart. Pitch yeast.
#6 6-12 hours later, dry hop with jasmine tea. (I dry hopped right away and it all blew off)

SVME-Waltham student essay contest

2009-05-27T08:34:00.005-05:00

I am happy to announce that Megan won something again! The 2009 Society for Veterinary Medical Ethics-WALTHAM student essay contest, on the subject of "Alternative and Complementary Veterinary Medicine and the Role of Veterinary Regulatory Boards." Megan will receive a a cash prize, and $1,000 for travel and expenses to attend the 2009 American Veterinary Medical Association conference in Seattle Washington this July, (during Megan's 1st vacation block!) as well as a year long membership to the Society for Veterinary Medical Ethics. The essay entitled, "Opening the Door: Non-Veterinarians and the Practice of Complementary and Alternative Veterinary Medicine," will be published in an upcoming issue of the SVME newsletter. I will link to it once it is published.

Megan worked very hard on this essay, and we are both really excited that it won! I couldn't find a good image, so I made my own old-school animated corgi GIF. Congratulations!

Rotation #2, week one: Critical Care

2009-05-26T12:53:00.003-05:00

My second clinical rotation is actually two rotations in one. They decided this year to combine the Emergency and Critical Care rotations into a single two-week block instead of two separate blocks, because so often the animals that come into Emergency end up in the ICU. The two services work so closely that students often end up working on both anyway. Last week, I spent my time on Critical Care.

The Small Animal Intensive Care Unit is a hodge-podge of all sorts of cases. The ICU is where animals go as they are recovering from surgery. It's often where animals who are seen on ER end up as they recover or wait to stabilize enough to go to surgery. The Internal Medicine service often has ICU patients, like when a pet who comes in to be assessed for increased frequency of urination gets diagnosed with diabetes and needs time to get stabilized and started on insulin. The animals in the ICU are usually not far from some sort of impending crisis, which is why they need to be monitored so closely and need to be close to lots of people who can act quickly if something bad happens.

In the past week, I saw my first grand mal seizure in a dog (terrifying). I've learned how to take blood pressures using a Doppler, learned how to set up a CRI (constant rate infusion), watched a classmate remove fluid from a dog's abdomen, and saw my first case of pericardial effusion. I saw a dog who got put on a ventilator to breathe for her after meningitis caused his brain to swell to the point that he lost control of his respirations. We made a lot of sad diagnoses (cancers mostly, or poor outcomes following surgery), but also got to send a lot of our patients home after they made it out of the woods. I helped take care of a litter of kittens post-C-section, and got to send a tiny puppy patient home after he recovered from a pretty major head trauma.

Critical Care is a place where the swing between hopelessness and miracles occurs 10 or 20 times a day. Sometimes all the monitors, tubes, medications, and blood tests seem so invasive and pointless... but then there are cases where your patient looks a hundred times better after receiving a liter of fluids, or that one EKG tells you that your patient is turning the corner, and it all suddenly makes sense.

I'm still not sure that I'm built to handle the wild swings between elation and sadness that come with Critical Care, but I will say that the feeling of getting a hug from a client who gets to take their dog home after five long days in the ICU is worth a million bucks.

No Comment

2009-05-23T17:00:00.003-05:00

In our parking lot, since last night. Click for the full size version. Yes, that is lipstick.

Supervillians

2009-05-22T11:00:00.005-05:00

This isn't my original thought, but I really think the Republican party is relying on the belief that those people currently held in Guantanamo bay are literally supervillians with super powers. Flight, X-ray vision, super strength etc. Thus we need to hold them in Guantanamo because it is made of adamantium and as Steve Benen says, "surrounded by sharks with frickn' lasers on their heads."

No, we made Guantanamo from spare parts anyone could find at the Home Depot. And if someone escaped they would escape to Cuba, perhaps one of the safest/sympathetic places they find themselves! Of course the reason they are in cuba on a military base isn't to keep detainees out of America, it was created preciously to keep them out of the American court system.

I have written before about the Green Lantern school of foreign policy. Perhaps this is the Magneto school of detention policy. Watch this (violent) video from X-Men 2 if you don't know what I am talking about. And as if to drive the point home, the RNC has released this web ad, copying the famous "Daisy" ad used against Goldwater in 1964. Who knew that the prisoners in Guantanamo were so dangerous, that they actually have the ability to from a nuclear weapon inside their own bodies, using only the power of their mind. That is the reason we can't have them on US soil!

It all makes sense now.

Megan's KHS 500

2009-05-21T21:52:00.009-05:00

Here is Megan's new toy, a KHS 500 road bike! Carbon fork and chain stay, aluminum all the rest. Megan has outgrown her old bike, which will be used as it has been as a comfortable commuter hybrid with fenders, rack, and basket. But, all that weighs almost 40 lbs (with out a backback!) while this one comes in at just above 20. Plus all the benefits of road tires, shifters and brakes. Also known as... much faster!

We took it out to the fair grounds so Megan could get a handle on the very different feel of this bike. It really is like the difference between the Volvo and the Scooby. Everything gives you a much faster response from turning to braking to shifting to accelerating. Perhaps a little less comfortable to ride though! But after a short time riding around, Megan was riding confidently and speedily. I got this photo as we were zooming down a small hill.

Last night we went over to the family bike shop and the bike got a full work over. We added an "interrupter" brake on the handle bars (like my bike) so you can ride upright and still have the rear brake available. It also got a new stem installed so the handlebars are a little closer, and it is better looking too. Today we stopped at freewheel to use our coupon and get Megan a new and much better helmet (not pictured), water bottle cage, saddle pouch, and extra inner tubes. So she is set for a summer of riding!

On our way home on the transit road, Megan kicked it into her highest gear, which is at a ratio that my bike can't reach. I had to spin fast to just keep up! See you out on the trails...

Rotation #1: Necropsy

2009-05-14T12:40:00.004-05:00

My first rotation as an official fourth year veterinary student is Necropsy- where "all our clients are sad and all our patients are dead," as summed up by one of the pathologists. Necropsy (Latin for "study of the dead") is the animal version of an autopsy (which literally translates to "study of self", which is a little weird... think of it as "study of the dead human"). The Minnesota Veterinary Diagnostic Lab offers necropsy services to clients of the Veterinary Teaching Hospital as well as to the general public. A necropsy is a thorough examination of a dead animal, including the external anatomy and internal organs. We examine everything grossly (using just our eyes and hands), and then take samples to make histologic slides to examine everything microscopically. Sometimes, depending on the case, we also submit samples to look for bacteria, viruses, fungi, and parasites.

So why exactly do we perform necropsies? There are a few reasons... Sometimes it's just because an animal's owner wants closure about why their animal died. They come home and find the pet dead, or the pet suddenly developed disease and had to be unexpected euthanized. For some people, knowing what happened is an important part of the grieving process.

Sometimes, a veterinarian requests a necropsy because his treatment didn't work, or he recently performed surgery on the animal. In that case, they are looking to see if they did something wrong (did my sutures come loose? did I misdiagnose the disease?). Knowing what went wrong can help improve how they handle cases in the future.

For people with breeding kennels or farmers with herds of animals, a necropsy can help determine if an infectious agent was the cause of death. Knowing that one animal was infected with a certain bacteria or virus can help them change their management protocols, provide treatments to their other animals to keep them from getting sick, or help guide treatment of other sick animals on the farm.

Last, there are the CSI-type cases. I think my neighbor poisoned my dog, or I think the horse you sold me had a congenital defect that caused its death, or my cat died as soon as I switched brands of food so I think the food is toxic. In these cases, we take lots of photos and make sure our notes are extra clear, because it's not unusual for them to end up in court.

Sometimes we can find a cause of death. Sometimes we find evidence of disease, but not necessarily anything that explains why the animal died. And sometimes we come to conclusions like we did today- "We can find no abnormalities in this animal, so clearly it is not dead." A lot of times, death comes without leaving any obvious evidence why- heart rhythm disturbances, electrical abnormalities in the brain, electrolyte problems in the blood... Unfortunately we all too often can't find any particular cause of death.

Aside from necropsies, pathologists also work with biopsy samples, like tumors that have been surgically removed, or diseased tissue, like inflammatory bowel. They are the ones who can tell you what type of tumor that animal had, which has serious implications for the animal's cancer treatment and prognosis.

Overall, I think necropsy has been useful. It's a great review of anatomy, if nothing else. Pathology is also the intersection of clinical science and basic sciences, so we've had to synthesize everything we've learned over the past two years. For example, when we read in the clinical history that a dog has been on prednisone (a steroid) for the past three years, we have to consider what changes that drug would have made in the dog's body (a big liver) and why (because prednisone makes the liver cells prone to storing glycogen). It can be really exciting to make a diagnosis of a strange disease, or to put together a puzzle of how the history, clinical signs, and necropsy findings fit together. But, I'll be glad to move out of the D-Lab and into the hospital, where our patients are alive!

Next rotation, starting Monday, is Emergency and Critical Care.

Democrat Party

2009-05-13T08:27:00.005-05:00

Atrios once said that he enjoyed the right-wing pet name for the Democratic party, the "Democrat party" because it acted as a filter. Those who insist on dropping the "ic" from the end, in what I assume is meant as some sort of insult, are simply highlighting their own impolite motives and thus, shouldn't be taken seriously anymore.

Now, behold: GOP, RNC to rebrand Democrats as the “Democrat Socialist Party." The Onion couldn't have done better.

Note that is happening at an extraordinary special session next week, and is 1/3 of the agenda. The other parts are resolutions "rejecting earmarks" and commending themselves for opposing “bailouts and reckless spending bills.”

It's official

2009-05-12T22:52:00.005-05:00

I am actually, truly, for real a fourth year!

I plan to write about rotation #1 soon, but for now, a few pretty photos from the Shepherd's Harvest Sheep and Wool Festival this weekend...

Racism, not always what you think

2009-05-05T11:31:00.002-05:00

As a coincidence, Ta-Nechisi Coats at the Atlantic has great post on the debilitating long term affects of racism and bigotry for those who embrace it. It includes my new favorite joe-the-plumber quote, who we learn has gay friends but they had just better keep their "queer" hands away from his kids.

Bil-Jac Pet Foods Nutrition Scholarship

2009-04-24T12:55:00.005-05:00

Congratulations to Megan for winning the Bil-Jac Pet Foods Nutrition Scholarship this year! The U has a very boring discription of the award, so I am stealing it from Kansas.

"Student must be a second or third year student in the CVM, student should be enrolled in small animal studies, student exhibits scholastic achievement in the upper 1/3 of his/her class, and should exhibit a desire to promote greater awareness of small animal nutrition."

That Megan does. Congratulations! Winnie is for spending it all on dried liver...