To the best story goes the best care?

Filed under: @ 9:08 pm

Matt, having extensive experience in emergency medicine, probably knows the answer to this, but he probably can’t tell me. When you enter the realms of emergency medicine they probably make you take an oath not to reveal Certain Workings of the average ER on pain of being transferred to the maternity ward or something.

So since the genesis of this story begins with Chuck’s heart murmur, y’all will have to excuse me while I lay down some background.

Chuck, who will be 26 next spring, has never, EVER been an easy feeder.
About two years ago Chuck started in on one of his prolonged fasting periods. We’re familiar with them and they’re not unusual for male Ball Pythons so for a while we just ignored it. When the fasting had gone on for what we deemed long enough we started to assist feed (basically dip a dead mouse in olive oil and shove it down the snake’s throat…. isn’t veterinary medicine glamorous?).
Chuck, usually a fairly placid and phlegmatic snake, resolutely refused to be assist fed. We’d get the mouse partway down his gullet when *YACK* back it’d come.
So I took Chuck to my buddies at The Bird and Exotic Clinic of Seattle. In short order Tracy diagnosed a heart murmur, Dan ran his ultrasound over Chuck’s chest, we all agreed that Chuck’s heart looked a little enlarged and I arranged with a cardiologist friend of mine to do a cardiac ultrasound. For what it’s worth, if you want to make a veterinary cardiologist happy, ask him to do an ultrasound on a species that he’s never examined before. Toby was enchanted to be asked to do an echocardiogram on a snake.
So Chuck has been on heart meds ever since. Sometimes the medication works and he eats, sometimes it doesn’t and he won’t. When Chuck won’t eat voluntarily we tube feed him. We both realize that this is a failing proposition and Chuck’s end will come sooner rather than later, but for right now, tube feeding it is.

Chuck has refused to eat now since mid-June and we’ve been tube feeding him a revolting slurry of warm pureed canned cat food mixed with this horrendous powdered stuff called Carnivore Care. Tube feeding what basically amounts to a tube is really pretty easy. You make up your horrid slurry, fill a 60cc catheter tip syringe with it, attach an 18 gauge red rubber feeding tube, shove the feeding tube down the snake tube then fill the snake with the slurry. Easy peasy. Except when it isn’t.

Something went wrong with our feeding efforts today. The canned cat food we’ve been feeding the cats (and thus the snake) recently is (ergh) a little chunky. I thought I’d mashed up all the chunks, but one apparently got through and was craftily big enough to fit into the syringe, but not big enough to fit all the way down the feeding tube.
So we’re about 15cc into feeding when SPLORTCH!
The feeding tube disconnected from the syringe and the pressure I’d been applying to the syringe resulted in me firing pureed cat food and Carnivore Care *everywhere*. All over Andrew (he was holding the snake), all over the stove, the ceiling, the cupboards. The syringe wasn’t completely empty and Chuck hadn’t had near as much slurry as he needed, so we rolled our eyes, said a few Special Words, and re-attached the syringe to the feeding tube to finish the job.
Okay, NOW we’re done.

Andrew went to put the snake back in his tank and mop himself off (he was _drenched_), I went to grab rags and buckets and was presently standing on a chair in the kitchen mopping the sludge off the ceiling.
Andrew came in, sans pureed cat food, with the mop. Much frenetic cleaning.
Andrew had to move my chair to mop so I got down and was wiping down cupboards when I noticed more glop on the ceiling. I asked Andrew to shove the chair back to me so I could finish up.
“Okay, but be careful, the floor is slippery!”
So standing on a chair on a wet kitchen floor with soapsuds running down my arm and pureed cat food glop dripping from the ceiling I suddenly started to laugh.
Andrew asked me why I was laughing.
“Understand that I don’t *want* this to happen, but…. what do you suppose the reaction would be in the ER if I did fall off this chair and crack my head and when they asked me what had happened I said ‘Well, I was cleaning up the ceiling in the kitchen after I’d sprayed pureed cat food all over while trying to tube feed my snake…’ I mean, especially if you brought me in covered in pureed cat food and me with glop in my hair and (ecch!) in my EAR….”

Which got us both to wondering.
Sure if you’re in a car accident and break your arm you’re going to get care at the ER. They’ll be efficient and so on, but you know the attitude would be something along the lines of: “meh! It’s just a car accident. It’s just a broken arm.”
And the guy that comes in after having been “baking an apple pie in the nude and I slipped and fell on the apple but my hands were covered with butter and the apple was slippery and….” is going to get a LOT of attention from the ER nurses, the on call proctologist, and any random intern that happens to walk past. But probably, people being people, the ER staff is probably going to make you wait if for no other reason than they’d have to stop laughing before they could attend you. And probably at least _some_ of the wait would be what we tend to call a “stupid tax”.
But what happens with the person who has injured themselves in some spectacularly weird, and yet verifiable, way that isn’t a result of stupidity?

And I really _didn’t_ want to fall off that chair and crack my head on the soapy floor, but I’d probably have gotten a _lot_ of attention if I had.


Just a Passing Thought

Uncle AndrewUncle Andrew
Filed under: @ 8:44 am

There has been a lot of chatter lately about the Authorization for Use of Military Force. I have little to say on the matter, save this: I don’t feel comfortable with any governmental doctrine whose acronym sounds like a monster swallowing the world in one bite.




Filed under: @ 11:29 am

One one of the roads I take on my way home from work (Yes, I drive a different route to and from work. Don’t ask why, it’ll just make you crazy.) there are rumble strips across both lanes.

I am not sure why there are rumble strips, possibly to make people more aware of their surroundings – it’s a residential street but a busy arterial – but there it is, the rumble strips are there.

Every day on my way home from work I try to aim my tires so that they go in between the rows of raised bumps. Again, I’m not sure why. Maybe it’s the challenge, maybe it’s an innate need to not have any more noise than is absolutely necessary at the time, who knows?

I’ve driven this route almost exclusively for the last 8 years. And every single time I try to miss the bumps. However it’s only been in the last several months that I’ve noticed that other cars mostly do the same thing. Probably 90% of the cars I see driving in front of me adjust their tangent a little bit so they miss the bumps (or not). I have never seen anyone purposely shift so as to hit the bumps.

And on my way home the other day I got to wondering. Both why *I* do it and why everyone else does. I’m sure there’s some explanation for it….. or at least someone who could come up with a plan for a scientific study to look at the phenomenon (if anyone was interested) and I find the idea of studying it rather fascinating.
Then I remembered that I don’t like most people very much and decided that maybe sociology won’t be my next career.

(For the record I manage to not hit the bumps about 80% of the time.)

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