So we're wiping to Shad'har- 2% wipe! We totally have it tonight. I should probably give our under-geared pally a vantus rune.....
But while I lie dead on the floor there, I thought I'd write about something that has been ruminating in my head since Friday: I had a St Bernard spay on Friday. >100 lbs, wasn't looking forward to it. It ended up going fantastic, my tech was impressed by the small incision, and no complications! (until my tech sent me a text in the middle of this raid that the dog tried to scratch out her sutures, lovely.)
But- I offered a gastropexy, tacking the stomach to the body wall to reduce the risk should the dog bloat. Colloquially called bloat, GDV (gastric dilatation volvulus) is when the stomach fills (dilatation) usually with air though sometimes with food, and twists (volvulus), a condition more common in the large, deep chested dogs- great danes are the poster children for this, but we offer it for all large, deep chested dog spays. Gastropexy (stomach tacking) is tacking the stomach to the body wall so if the dog were to bloat, the stomach would not twist- the twisting cuts off blood vessels. The decreased blood supply to the stomach, spleen, and gut can be really dangerous- it only takes a short time for the intestines to die once their blood supply has been cut off. Gastropexy makes bloat a little bit less dangerous, since the stomach doesn't twist, just bloats, which we can decompress without surgery. Otherwise GDV is a surgical condition, with (depending on a few factors) a potentially poor prognosis. I will always offer euthanasia as an option for GDV. If you can't do surgery, euthanasia is the kindest thing to do.
Anyway- I was glad the client declined the gastropexy. I was really stressing out- I had a bad dream about work stuff related to the gastropexy, I was worried my nurse would forget to offer it, and then I was worried I'd forget to quote the cerenia (anti-nausea medication). After tacking the stomach the LAST thing I want is for the dog to vomit, and tear all my sutures out. I was watching videos I've only done 2, and none solo) and then the client declined. And I was relieved. I would not have to miss lunch with the unexpected extra surgery time for this dog, since the schedule was poorly done that day, and it was a Friday which already goes to hell most weeks.
Woo, Shad'har down! Writing this from Hivemind's floor now.
And it's been eating at me- am I a bad doctor for being relieved that the client declined a procedure that is in the pet's best interest long term? And this is not the firs time- I HATE pulling teeth, especially broken carnassials (the really big teeth at the back). Diseased teeth that are about to fall out anyway? Sure, I sometimes remove them free of charge with "aggressive cleaning" but extracting broken teeth sucks. I tell people who ask me "Do they really have to come out?" that the phrase "it's like pulling teeth" exists for a reason- pulling teeth sucks. So sometimes I'm relieved people decline- and most of the time it'll be fine, but the worry about tooth root abscesses is real so I do go over the signs to look out for. But is it a bad thing that I am occasionally relieved I don't have to to these procedures?
Intellectually, I know there are doctors out there who refer for anything they don't feel comfortable for, which in some cases includes things I find simple. And I did offer, and was willing. So I don't feel bad-I totally would have done the procedure. I may not have gotten lunch, but it would have been done. But I didn't need to.
I will have to remember that I offered the best care for the pet, and the owner declined. The old phrase, you can't care more than the owner does, comes to mind. I just want to be super!doctor some days, and I'm not. Most days I feel like acceptable!doctor, and continue to work towards being the best veterinarian I can be. And no one knows everything. That's why we have specialists to refer to and learn from!
And now, onto WoW woes! First, the lag tonight was real- repeatedly lagging out on bosses. We did get a new boss down, so yay there. I'm still struggling with feeling useless- no longer a raid leader, never a good healing lead- I made one attempt and gave up when the raid leader came up with a better plan. I've always been a fly by the seat of my pants healer. I used to do 10 mans, with the same 3 healers who I knew well, so I knew how to anticipate CD usage. And we never really assigned anything. In mythic, assignments are needed. Our raid leader off spec does whatever we need, but mostly heals. And does it on disc- which I suck at. I am trying to learn- I believe I resisted mostly from stubbornness, but also discipline just does not click with me. I did challenge modes as disc way back in Mists of Pandaria, when it was really easy. Now, it's something I have to pay attention to constantly to do moderately decently, where as every other healing spec I do takes way less attention. And from a contrary point of view- I love my resto druid. At the start of the tier I really looked forward to playing resto. Some drama with a new guildie who was promised the only resto spot (may discuss someday- old news, not important) meant I swapped. And we did not have a healy priest. And the leader that that time (not me, not the current one- also old news, may discuss someday) thought a disc priest would be good. Really everyone did. So of course I couldn't play disc. And it just doesn't click, and I have limited time to learn. I'm working on it now though! Angel of death announcing when I failed is not fun.
I forget where I was going with that thought- that I struggle with a role in the guild that I am an officer in in WoW? That I feel unneeded in a raid I used to lead in said guild? I am glad not to be in charge anymore- our current raid lead does much better than I ever did. Which some days also makes me feel bad. But most days I am glad about that. And I try to remember people have different strengths, and I probably bring something to the table, even if it's just putting down the feasts/making the cauldrons.
But for now, I am going to stay up a little bit later than I should doing some mythic plus, since tomorrow is going to start with an early appointment (going in 45 min early) for a quality of life appointment (read: probable euthanasia) for a patient of mine who is basically on palliative care. I am sure I will write about her later.
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