Last night as we did our nightly ritual of all piling into our king size bed for a quick cuddle, Drew was super excited about a bag he had found deep in the recesses of one of his drawers.  It had some old stuff in it I use to take to my Mom’s when he was a baby in case he would ever get sick.  Things like a thermometer and Vicks and who knows what else.  I was half dead lying next to Drew in bed when he said “Open up wide and say AAHHH Mom”, and then stuck a thermometer into my mouth.  It took me a few seconds, but then I realized…this was likely a rectal thermometer!  Chad almost fell out of bed he was laughing so hard.

I also struggle with topics to write about.  Usually I tell my staff ridiculous stories of my kids…so you might have to hear some of those…and I will try to throw in some more animal related stories as well.  I also have great stories about patients and clients…but have to figure out a way not to offend anyone (especially if one of those clients follows this blog!).

For example, today I had a strange character present with his girlfriend and cat for a re-check on a sore we were treating (the way we treated it was pretty cool.  The wound really needed surgical repair, but the owners couldn’t afford it.  So we did what I call “sugar wound management”.  It is a hundred year old remedy using table sugar to help in wound healing.  Dr. Neil thinks I am off my rocker for doing it…but it has worked every time!  His wound looked great and all healed up today).  The boyfriend wasn’t here for the initial presentation. Today he asked me if this wound could have been caused by aliens exiting the cats body?  I kid you not!  How am I suppose to remain professional in a situation like this?  I mean really?!?   But I did…and simply said “Not likely, although there are some parasites that could do this…but I don’t think that was the case here.”

I got a lot more of those where that came from!  You can’t make this stuff up!

My day started around 5:30 AM after a fitfull night fighting the 10 lb creature that insisted on lying on top of the covers in my leg space all night.  The kids spent the night at my parent’s so I was looking forward to a restful full night of sleep, but to no avail. I am still not convinced that there weren’t other creatures up there with Hally, because it sure felt like more than 10 lbs holding down the covers, but my feet never made full contact with two separate bodies at once so the jury is still out on that one.  I do know B.B. was not locked up in the basement last night so in all probability her fatness was up on the bed too.

I rose, went for a nice 3 mile run and proceeded to pick my Ms. Emily up from my parent’s so I could take her to her 18 month check up before my morning of work started.  I am completely biased, but my opinion has been confirmed multiple times that Emily is absolutely adorable (also by my staff…so it makes me wonder if they are just agreeing because I am their boss).  Her blue eyes and blond curly locks are to die for.  My Mom had her all done up and looking so sweet.  Off we went.  We got ourselves seated in the waiting room and immediately Emily insisted that she take off her shoes and socks.  I figured why not since we would soon be disrobing her anyway.  Good idea until the nurse called us in and Ms. Emily then insisted on walking to the exam room across a carpeted lobby.  Really?  Carpet?  In a medical facility? So I cringed a bit (but it was no worse than her eating two handfuls of mud later in the day…).  As we entered the sterile exam room Emily took one look at the crinkly papered exam table and started screaming bloody murder.  No one had touched her or talked to her but her screech ensued.  The nurse asked me to take her down to her diaper and meet her at the scale.  Sure thing.  Now the cheese filled crackers Emily also insisted on having while in the waiting room were flying out Emily’s mouth, covering her hands which were now clutching to me and my work scrubs for dear life.  I should know better than to actually be dressed for work and then handle my children.  As Lisa would say “Really?  Really Becky?”  You’d have thought this was my first day at the rodeo, but I assure you it is not…I blame that damn cat for lack of leg room and sleep.

I managed to disrobe Emily just in my arms because the moment I would try and lie her down on the ever so sterile protectant paper covered exam table she screamed even louder.  And really?   Who are we fooling with that paper covering anyway?  Women, you know what I am talking about.  It never stays in one place.  It IS NOT absorbable; it disintegrates as soon as moisture comes in contact with it.  And it does not hold up well to cheese filled crackers. The only true use I see for it is drawing on it to measure how tall my child was.

Okay, undressed, weighed and measured.  We were the first appointment of the morning so the doctor was right in (so you see…not my first day at the rodeo) .  Emily didn’t scream immediately.  We had our pleasantries and then the exam began.  Every time he put his stethoscope to her chest she swatted it away.  Finally he gave up and just listened to her back, which of course made her wiggle and squirm into my arms.  The ear exam went well, causing much screaming which only helped the oral exam.  Technically today she was not due for any vaccinations but her ever so wise and diligent Mom said why don’t we both get our flu vaccines over and done with…nice Mom I know.  I got the mist, poor Emily got the injection.  Alright, done and off back to my parent’s to drop Emily off for the morning and to work I went.

I have varying schedules on Wednesdays and today was my half day.  Unfortunately it wasn’t a great day.  I will take a moment here just to fill you in on a great loss of our clinic dog, Rocky.  Rocky came to us this past March and was adopted by a great woman.  Today we made the difficult decision to euthanize him.  I won’t go into the details, but we all cried together.  This one was really rough on me.  I don’t tend to show much emotion other than comfort at euthanasias.  I find that I like to keep control of the situation and exam room happenings.  Today I just let it go and cried with the family.  Rocky stayed with my family and me for over 6 weeks so I felt like a small part of him was mine too.  My job entails doing many euthanasias (to date I have probably performed close to 400) but this one hit home.  I try not to bring this home but Rocky and his Mom will be in my thoughts for awhile.  I drove home in a somber mood and shed a few tears with my Mom when I got to her house for the kids.  She knew Rocky as well and fell in love with him.

My somber mood was replaced quickly with the managing of Drew and Emily for the rest of the afternoon.  Drew is on a hunger strike of sorts.  It was well past noon and he refused to eat anything other than a fruit roll up and some chocolate milk.  Emily on the other hand ate everything I put in front of her.  It was a gorgeous day today.  The kids have been cooped up inside for a few days with all this rain we’ve had.  So I insisted we were all spending the afternoon before naps outside.  First order of business…poop patrol.  Drew saddled up in his Power Wheels 4×4 Jeep and scouted the perimeters.  Emily carried the shovel part of the pooper scooper.  Every time Drew spotted some poop he would yell at the top of his lungs “POOP” and Emily would laugh and run with the shovel so I could scoop it into it.  We got most of it and luckily none of it got on us.

The kids have managed to create another “sand box” next to the actual sand box and played there for a while.  As I was sitting on a patio chair checking some email and enjoying the serenity I stopped for a moment and looked after my darling children…just as Emily put a handful of mud into her mouth and said “yum yum”.  I of course hollered “Emily don’t eat that”, which was then followed by yet another handful of mud!  And this folks is how children get roundworms.

Our next bit of excitement was when Drew spotted the tree frog that has been living in our backyard in the kids playhouse and somehow has managed to survive the summer at the hands of Drew.  Drew has now learned that we don’t squeeze the frogs and when they turn from green to gray it is time to put them down.  Today he did really well at not squeezing.  But those darn things are sticky and so he had to flick his hand several times to get it off which sent the frog flying from the height of 3 feet to the cement patio several times.  New rule, no squeezing and no flicking it off your hands no matter how stuck you really think it is to you.  It is however okay to put the frog at the top of the mast of the play pirate ship water table and call it “Captain”.  After a while of going down the slide together Drew nicely placed the frog on a tree while it was still green.

Of course during all of this the cats wanted to be outside with us.  Hally is not a problem.  She has spent the entire summer from morning to late in the evening living in my flower garden.  She comes in to eat and back out she goes.  Winter is going to suck having to listen to her howl at the back patio door!  B.B. as of late has escaped the fenced in back yard twice now.  Today I saw how she did it.  She actually squeezed her fatness under the gate that had about a 3-4 inch clearance at the bottom.  I caught her mid-body.  There is now a log in front of the gate.

Nap time arrived and thus ended my craziness.  Chad came home and took over so I could go to our CE dinner tonight.  After telling the ladies all of this, Lisa said, why don’t you write about that…so there you have it…as Buddy lies at my feet and Hally is asking to go outside…a day in the life.

My parents have a dog, Mr. Gus, a wild 7 year old Cairn Terrier (that we have only me to blame for picking him out of the litter with a vet school friend per request of my father as a gift to my Mom) and an unknown aged cat, Ms. Pumpkin (also only me to blame as she was a “clinic cat” that somehow my cat disliking father fell in love with and she has now lived with them for the past 4 years or so).  Both animals are fabulous…that is under their own roof and under the care of my Mom.  So when my parents travel for lengthy times, which isn’t often, they choose to kennel them at one of our clinics.  We’ve tried having me stop by (since I literally live a block from my parents) but this has become increasingly difficult with my little ones.  They are either napping, want to tag along and then throw a fit when they realize that Maymo and Bompa aren’t actually home (which I try explaining to them as if I were silly enough to think they would understand and grasp the concept of not being home) or I just plain forget to check on them.  That can fly when you have cats…dogs demand a little more attention!

Per a request by my Mom, who was feeling very guilty that 11 days at the clinic was going to be too long, asked if I or my sister could occasionally take them to our houses for a romp.  I thought, sure no sweat, Mr. Gus and Buddy love each other and Drew would think it was a blast to have Mr. Gus here.  Yesterday I naively had Tammy and Tiffany crate both the animals up and they met me at the doors to help load them into my car, kids in tow.  Great, so far so good…except for Ms. Pumpkin meowing at the top of her lungs the entire ride, which made Drew ask about a thousand times if she was crying and then about half way home Emily starting meowing and wouldn’t stop either.

I pulled into the garage, left the kids watching their movie and let Mr. Gus and Ms. Pumpkin loose in the house.  I finally got the kids in the door and Buddy and Gus were chasing each other like maniacs.  Buddy is not a young man anymore, but he sure was acting like a puppy.  I kicked them both outside before the house was demolished.  Ms. Pumpkin went off “exploring”.

The kids and I headed outside to hang with the dogs.  Gus was so happy!  It was hilarious.  Drew and Emily were squealing and the four of them were running around like idiots.  I was slightly concerned that someone was going to get hurt, but it all seemed pretty harmless.  Then Drew and Emily got in the Power Wheels Jeep and it was on.  Mr. Gus hates buzzing or high pitched noises of any sort.  You can’t ever watch the TV without him wigging out and charging the television.  I should have known better to let this all occur.  Before I knew it Drew was driving and Gus was chasing the front tires!  I had visions of a smooshed Gus.  Somehow he managed to avoid being runover by my 3 year old driver.  I let this ensue for a few minutes, then finally put a stop to it.  How would I explain a dead Mr. Gus to my parents?  I told them before they left, if anything bad happened, if anyone died, we weren’t telling them until they returned.  We weren’t going to ruin their trip of a lifetime…but I am not sure they would have forgiven their veterinarian daughter if I let my kids kill their dog with the Power Wheel.  Next Drew decided to “mow” the lawn with his bubble blowing lawn mower.  Gus attacked the mower and tried ripping it out of Drew’s hands.  Drew thought this was hilarious so he kept on running around mowing.  Finally, after seeing blood coming from Gus’s mouth I had to put an end to that too.

Gus was now breathless, Buddy was laying lazily in the shade and the kids were bored.  So we moved back inside.  There, Gus ate most of Buddy’s food, giant T/D bites which he managed to make crumbs all over the kitchen and  leave a trail into the living room.  I finally wised up and picked up the food bowl.  As I was running into the kitchen to shoo Ms. Pumpkin off the counter, Gus attempted to pee on the kids’ toy box!  Okay, that was it!  I picked up the phone, called Tammy and informed her not to clean out their kennels…they would be heading back before closing time!  As I made that call, Ms. Pumpkin had gotten cornered in the laundry room by Hally and B.B.  They were growling and hissing and wouldn’t let her out.

I texted Chad, asked if he would do me a huge favor while the kids were napping and please take the animals back to the clinic!  He wanted to know what the heck I was thinking by having them over anyway?  I explained I thought I could handle it, it seemed like a good idea at the time!  This is my mantra…according to Chad.

Mr. Gus and Ms. Pumpkin are once again safely tucked away at the clinic.  My sister, who said she would take Mr. Gus a few days this week has since reneged.  Apparently she has a bit of landscaping issues at her house and too much mud.  She is smarter than I and won’t attempt the craziness or mud in her house!

To top it off, Chad is working 30 hours of over time this week…so I am flying pretty solo during the day…thank goodness he is home for bedtime routines.  Maymo is back on duty on Monday when I will head back to work full time again…and that is when my vacation can resume.

I was feeling pretty good as the four of us walked through the church doors smiling and five minutes early.  I got both kids quite easily through the children’s service and all settled into the nursery.  So I sat back to enjoy the rest of the service.  As I did, I took a look around me and realized I was surrounded by at least 7 clients!  I was feeling pretty good about that and even leaned over during offering time to tell my Mom.

After the service I usually rush out the side pew and head down to the nursery to retrieve the kids.  This day I decided to take my time and go through the receiving line and say good morning to everyone.  While in line I said hi to one of those clients and she commented how great she thought the upcoming dog wash was and how could she help.  As I said thank you to her I found the pastor’s Mom, who during that week had been caring for her daughter’s dog while she was on vacation and managed to lose the dog!  We care for that dog so I wanted to touch base with her and make sure she found Jeffrey.  She in turn told me the most hilarious story about how Jeffrey was found down by the boat launch in De Pere and the people that found him grabbed him and took him sailing for the day!  They didn’t bother calling until later that evening once they had returned from a day of sailing!  Of course the pastor’s family had been searching for him the entire time he was enjoying the water!  During that conversation another lady grabbed my arm and pulled me over to meet her adult daughter to inform me that she was an animal lover and she just had to meet the veterinarian!  During that conversation I was interrupted by yet another client that I had seen just a few days earlier.  He just wanted to let me know that the shot I gave his dog worked wonders and the dog was feeling great!  At that moment I excused myself to go round up the kids!  By the time I got there Bompa was already heading our way.

I’m pretty sure I need to attend church more often…it seems to be good for business.

Please forgive me for this shameless plea.  This coming Dec. 4^th I will be joining a dear friend, Dr. Betsey, her husband Jason, and my husband Chad in running a half marathon in efforts to raise awareness and funds for a cure for Crohns and Colitis.  Dr. Betsey is a fellow veterinarian that I met in vet school.  We have grown very close over the years and I care for her very much.  Shortly after vet school she was diagnosed with Crohns disease.  Dr. Betsey is a fighter to say the least.  One of the ways she started to manage her disease was by running.  She gave me the running bug last summer and I thus completed my first marathon this past May with her running the half marathon by my side!

This time around we thought it would be great fun to run as couples and run a half marathon together…in Las Vegas…at night!

Crohn’s disease and ulcerative colitis are collectively known as inflammatory bowel diseases (IBD). Crohn’s disease is a chronic (ongoing) disorder that causes inflammation of the digestive or gastrointestinal (GI) tract. Although it can involve any area of the GI tract, it most commonly affects the small intestine and/or colon. Ulcerative colitis on the other hand, affects only the colon. There are no areas of normal intestine between the areas of diseased intestine. In contrast, such so-called “skip” areas may occur in Crohn’s disease. Ulcerative colitis affects only the innermost lining of the colon, whereas Crohn’s disease can affect the entire thickness of the bowel wall.

It is estimated that as many as 1.4 million Americans have IBD; however, many more suffer in silence due to potential embarrassment and alienation. Crohn’s disease may occur in people of all ages, but it is primarily a disease of adolescents and young adults, affecting mainly those between 15 and 35. However, Crohn’s disease can also occur in people who are 70 or older and in young children as well. In fact, 10 percent of those affected — or an estimated 100,000 — are youngsters under the age of 18. On average, people are diagnosed with ulcerative colitis in their mid-30s, although the disease can occur at any age.

Together, we can make a difference! As a member of Team Challenge, I have a coach, a training program, and teammates to support me. I have committed to a training schedule with additional trainings with my team on the weekends, and I’ve promised to raise $3,600 in donations to The Crohn’s and Colitis Foundation of America. I AM MOTIVATED! I AM COMMITTED!! I WILL DO IT!!!

By now I hope you agree with me about the importance of this cause.  I need your help!  I need to raise $3600 to go and run for Dr. Betsey.  Donations are due by November 16, 2011.  Please help support me by giving generously.  Please consider giving $100, $50, $25, $10…but I would greatly appreciate anything you feel you can give for the cause.

Please go to my personal webiste for fundraising and make a donation today!

http://www.active.com/donate/LV11WI/LV11WisconsinBKrull

Please don’t be shy about passing this on to your friends and family and asking them to support me!

Thanks all!

Dr. Becky

So, when I have to go to my own MD I try not to be arrogant or argumentative, but it can be quite frustrating, because there are just some things I know more about than an MD.  Case in point.  Several months ago I treated a dog in kidney failure.  I grabbed a urine sample, but I was an idiot and did not follow aseptic technique/infectious disease protocol or have any concern for my personal well being and did not wear exam gloves…so I got urine all over my hand.  This usually doesn’t bother me and certainly doesn’t gross me out (I have kids…come on…let’s face it I have seen and touched much worse!).  So I washed my hands and went about my business.  About a week later I got a good scare and a lesson in safety.  The animal was Leptospirosis positive and in fact passed away from the disease after I sent it to the Fox Valley Animal Referral Center for care.

Leptospirosis is a bacteria-like organism (for those dog owners out there…we vaccinate your pet annually for this…it’s the “L” in the DHLPP booster) transferred in urine usually by contaminated water that a mouse, raccoon, deer or any infected mammal has urinated in!  It causes many things to happen to your body but one of them is kidney failure.  It is zoonotic…that means you and I can get it from these animals…including our dogs!

So when I learned that I had been contaminated with Lepto positive urine I started to sweat a little bit.  Usually the disease passes via mucous membranes…eyes, mouth or open wounds.  I usually have open cuts on my hands all the time, so the reality is that I could have been infected.  Again, more sweat.  I was breast feeding Emily at the time and sure enough…it can be spread via breast milk…more sweat.  I called Dr. Neil within minutes of getting the results.  He suggested I have a little Doxycycline with my coffee!  I agreed.  However, the drug of choice for treating this disease was contraindicated while breast feeding…so I reached for the next best thing and started myself on Amoxicillin.  I then quickly called my physician which is my OB because I am never ill and never have to go to the doctor other than to pop out some babies (well if you have read my latest posts…that’s not entirely true…but it use to be!).  They were completely unfamiliar with the disease and suggested I get in to see an infectious disease specialist.

I got an appointment with him a couple of days later.  Low and behold…he didn’t speak very good English…a very thick Indian accent (what is my luck with MD’s that I can’t understand?!?).  I explained to him the situation.  I was a veterinarian; I had been exposed to urine from a dog with a positive Leptospirosis result and that I wanted a titer done on my blood to see if I had an active infection.  In his very thick accent he said “very unusual to see…usually see in the jungle”.  I said, I know, I understand the rarity of this disease in Northeast Wisconsin amongst humans…but I am in a high risk category and I know I was exposed.  Again his response “very unusual…only see in jungle…usually military men in jungle”.  Yes, yes I know…but I was EXPOSED TO LEPTO POSITIVE URINE…calm down…and I am breast feeding and concerned about spreading this to my family.  I just want the titer done so I can see if I have an active infection and if I should continue Amoxicillin therapy.  He then proceeds to tell me all the things that could happen if I were infected, what my CBC and chemistry would look like…this goes on for about 15 minutes.  I tried to keep my calm…and I did a really good job too.  Finally…he says “you want me to run blood work?”.  I said yes.  “CBC and Chem?”.  NO!  Just the titer.  “Yes…let’s run a titer”.  Finally!  We are on the same page!  Then, just to really throw him for a loop I asked since they were drawing blood for labs could he order a Rabies titer…I thought he was going to lose it.  He said “what, you think you have rabies?”

As it turns out my titer for Lepto was negative and my Rabies titer is high…that’s a good thing.

I returned to the Allouez clinic Friday morning to my normal findings when I have been out of the office…a bombardment of medical records on my desk, post-it notes all over, and a great story from the staff.  This will be like the telephone game, so I hope I repeat it in the same, hilarious fashion Mandi and Lisa did to me.  It won’t be as good in writing…their reenactment was priceless…but I’ll do my best and they can fill in the holes later!

Apparently Dr. Neil was scheduled to see a fractious cat Thursday afternoon.  We identify these patients by marking all over their charts “WATCH”, “BITES” etc.  Often we in detail recant what  happened in order to “buy” that warning (I haven’t taken the time to see what this particular cat did and to whom).  So Mandi put the patient and client in an exam room and instructed the owner not to take the cat out of the carrier…but of course the client proceeded to take the cat out of the carrier.  So Mandi then instructed the owner at no expense…don’t let the cat in the little cubby that holds the paper towel under the exam table.  But of course…the owner let the cat get into the cubby before Dr. Neil was able to examine it.

Let me take a moment and pause from this story to explain the perils of the paper towel holder cubby.  I don’t know what idiot designed that room but they certainly weren’t taking into consideration the ever elusive cat…especially the mean, elusive cat!  The cubby resides under the exam table.  The opening is just wider than a roll of paper towel and the cubby goes deep under the table, like the entire width.  There is about a 2 foot space between the exam table and the counter behind it.  When you have to kneel down and peer into the abyss under there it can be frightening…there is no room to move should that beast decide to strike!  Then, once you have surveyed the land and are ready to reach in and grab on to the beast you have to do so almost blindly!  I have been attacked a few times.  Usually I can get a hold of the little bugger, but then cats have this miraculous gift of grabbing on (claws or not) and hanging on for dear life…so  you just about rip off their legs as you drag them out!

Alas, back to Dr. Neil.  The staff heard this horrific scream come from that exam room (with only the client and the cat in there).  They checked on them and it was the cat…the owner was trying to get the cat out of the cubby and the cat was in great protest!  The owner exclaimed “He’s never done that before!”  So Dr. Neil proceeds into the room to perform his exam and vaccines.  Mandi and Lisa offered to come in to help but he declined.  Apparently it wasn’t going so well and Dr. Neil asked the client to step out of the room.  Dr. Neil then asked for our “straight leash” which of course in a great time of distress and need the staff couldn’t’ find!  So he went for the fishing net.  Again, Mandi and Lisa offered their assistance and Dr. Neil declined.  So Mandi and Lisa sat outside the exam room door and witnessed, well…really heard the exciting events going on inside.  The impression Lisa made to tell this story was the best…she threw herself up against the wall and started flopping around.  At this point in the story I was laughing so hard that I was having trouble controlling my bladder and the laughter was causing severe back pain…but I couldn’t stop!  So the story goes on that even our clinic cat, June, became so concerned about the situation going on behind those exam doors that she even ran to sit and listen!  Finally, Dr. Neil exits the room into the lobby with the cat in the carrier.  In his calm demeanor and voice he hands the carrier over to the owner and politely says “Next time we should probably keep him in the carrier.”  He then walks past the staff…and this is the best part of the story if you know Dr. Neil…fixes his bangs and keeps on going about his business!  The imitation from Mandi again sent me into a laughing fit that had me chuckling at 1:30 AM this morning as I couldn’t sleep thinking about how I could re-tell this story as well as they did.  Lisa went in to clean up the exam room and it was a disaster…so much so that they took a picture.  Feces and urine all over.  The pamphlets were scattered everywhere.  Something broke (they never told me what).  Lisa said the only thing missing was blood spatter at the crime scene.

Okay…it wasn’t as good as Mandi and Lisa performing the story…but it was really funny!  Dr. Neil is so calm.  He never even let out an expletive, at least not one anyone else could hear!

Exam Room aftermath