back to basics

My office manager has been out for a full week, and will be gone for at least one more. My office manager, who has singlehandedly taken ownership of the clinic (in a good way), made sure that records are logged, bills are paid, papers are filed, forms are filled out and customers feel loved; my office manager, who I stay awake at night fearing she might someday leave me and wondering what else I can do to keep her happily employed.  Needless to say, I was slightly panicky at the thought of her being gone.

But really, it has been a good thing. Certainly I wish she was here, but her being gone has allowed two things:

1. For my other, excellent staff to step up. I have one other assistant who is fully trained on everything, and three “kennel assistants” whose primary responsibility has been taking care of the kennel, but as they are all smart, able-bodied people who are eager to learn and help out they have enjoyed learning the ropes up front. One has already been pretty much fully trained for awhile, and the other two are picking it up admirably.

When I worked for other people, I always tried to be invaluable enough that they couldn’t, or would never want, to lose me.   But now as an employer, I can appreciate the “hit by the bus” rule: never be in a position such that you would be crippled by the loss of an employee. Truth be told, I think I’d be extremely sad and lame if my OM did really leave, but at least this week has shown me that I wouldn’t actually be crippled.

2. For me to get back to the basics of running a business. Huge confession: Sometimes I fear that I like the logistics of running a business more than I like veterinary medicine. I know! Gasp! But it’s true. I love managing money, figuring out how to increase efficiency, decrease bills, appeal to clients, etc. Love it. I think I love it because it is more concrete easier than say, managing a dog in kidney failure. Ugh, having to figure out the calcium and phosphate and which meds to choose and explaining why a renal diet really is worth it, etc….that’s stressful. And it’s risky – screw up and your patient DIES. Screw up at business and you lose your money. Which obviously is not good, but still. Better than death.

So anyway, I’ve kind of enjoyed getting my hands dirty with all the stuff that I ALWAYS did my first year of business – managing inventory, talking to absolutely everyone who walks in the door or calls, making deposits, etc. Just the little stuff.  Taking out the trash. Sweeping floors.

I often say that my clinic is my first baby, but my boy is my favorite baby. And it’s true – my love for my boy is deeper and sweeter and better than anything else I could imagine. Fling myself off a cliff to ensure his well being? Just show me to the edge.  Would I fling myself off a cliff for my clinic? Um, no. Not even close.  But really, I love it so much.  I LOVE my staff.  I love my tiny little building. I really love my clients.  I love being able to walk into the backyard and be surrounded by 8 little yapping dogs who are here for boarding.  And I’m really proud of it.  I’m proud that this is something that I have created.

So as happy as I will surely be when my OM returns, I am somewhat grateful for being forced to remember how things “used to be”, and from whence I came.

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the demise of bedtime

A few weeks ago, my boy learned how to climb out of his crib.  Like the clever parents we are, we lowered his mattress to the lowest possible setting. And you know what? I swear, it made it easier for him to climb out. Unlike his mother, he is rather coordinated and careful, and while he never actually fell from his climbs, we figured that we shouldn’t test fate and converted the crib to a big boy bed. Sniff.

I sniff not just because my baby is growing up, but because I long for the bedtimes of two months ago, where I would lie the child down in his crib, and he would smile and say ‘bye bye’, and I would walk out of his room, and he might fuss for a few moments, but would quickly drift off to sleep.

NOW, not so much. We go through the same old routine – clean diaper and pajamas, clean face, brush teeth, read a few stories, sing a song or two, and get laid gently and lovingly in bed. What happens next? usually I gaze momentarily at his angelic, then tiptoe out of his room feeling like a total rockstar of a mom, only to turn around and have this 2′ creature grinning madly behind me clutching his stuffed bear. I march him back to bed, he lies down…I leave, he follows, etc. etc. What the hell??? My boy used to be a good sleeper! I try to go all supernanny on him and not talk, and not enjoy any of it at all, but sometimes he just gets to a point where he clearly thinks its a grand old game. And then what? Can I shut his door? Sometimes this ends the game and works, other times it makes him cry this terrible tale of woe that I just cannot ignore. For the record, I will gladly ignore a fussy-please-give-me-attention cry, but I really just don’t ignore the no-really-i’m-seriously-upset-and-crying-huge-tears cry. Life’s too short to cry like that.

So anyway, you get my point. Bedtimes are no fun anymore. It’s only been a week in the new bed. Maybe it will get easier before he leaves for college.

 

family fun time…sort of

It has been an absolute waste of a spring here in central Iowa.  We had several inches of snow on May 4th.  Then,  we had a super nice 10 days: the snow melted quickly, the fields dried out, the farmers started planting, life was good.  Then, it started raining.  And it got cold. And it kept raining. And it stayed cold. Now it’s June, commonly considered a “summer” month, and it’s about 60F out and the fields still have standing water, and the farmers are not happy. Neither are their wives.

So when last weekend loomed, my farmer and I realized it was the perfect time to get the heck out of here.  We thought about a quickie road trip – maybe 6hrs east to Chicago! Or 3 hours southwest to Omaha? Or 3 hours due east to Galena, IL, which people sometimes say is rather nice though I’m not sure why?  Unfortunately, we didn’t start planning until Thursday night, and I had a full day of appointments booked Friday, which meant we couldn’t leave early.  Friday morning we decided: road trip 1 hour south to the exotic and unusual Des Moines!

We booked a hotel with a suite and a pool, and loaded up the car with the dog and the boy (found a pet-friendly hotel).  Isn’t it weird how it doesn’t matter if you’re leaving for 2 nights or 20, packing for kids makes it a Big Huge Deal and is just never as simple as it seems it should be. But anyway, we got away.

And you know, even though we were just in Des Moines, where we go often, where my farmer lived for a few years, it was really, really nice.  No sitting around thinking, “I should be doing laundry!”, or “I should be cleaning!”.   He couldn’t sit and frown at the wet fields that he couldn’t work. We spent time together. We went to the Des Moines Farmer’s Market on Saturday morning. The farmers’ market used to be one of my favorites things to do – tons of vendors, fresh produce, wine tastings and yummy street food. And I still love it though now that I’ve lived in the country for a few years ALL THE FREAKING PEOPLE drive me a little bit nuts. Me and my farmer both, though he was a total sport for it.

It’s just amazing how getting away, no matter how close, was such a nice break! I highly recommend it for the stressed out among you!

3 years

My alma mater’s graduation was last weekend, which means that I have officially been a veterinarian for three years now. Three years!!! How is that even possible??

Vet school seems so long ago, but I don’t feel as smart as I should, 3 years out. I have been a vet for long enough that I can see a bit how my career is evolving.  I can see two very key, seemingly contradictory trends emerging:

1. I’m getting way better at NOT guessing. When a patient walks in with a common signalment, say a 15 year old cat with increased urination and weight loss, or a 18 month old Lab who has been vomiting for three days, i have gotten far better at not jumping to the obvious conclusions (kidney disease, tennis ball or other in stomach).  I have been wrong enough that I KNOW I need to shut off that instinct to guess and proceed with a thorough physical exam and appropriate diagnostics.  It’s simple, it’s obvious, it’s one of the things they DO actually teach you in vet school, and truly, it makes all the difference.  Every case I have that I work up properly and thoroughly goes well. Skipping steps gets me in trouble every time.

2. My instincts are improving.  As I get better at ignoring my guesses, I’m getting better at guessing correctly.  This is a simple consequence of experience. Which is nice. i have some now. Not a lot, but some.

Another crazy thing that I have noticed about myself is the guilt that comes with knowing what I know. It has just recently occurred to me that I feel TERRIBLE when I diagnose an animal with either a terminal or expensive illness. I just diagnosed a 100lb dog with Cushing’s disease, which is one of the most expensive diseases to treat, especially if you are a large dog.  When I got her blood work back that confirmed the diagnosis, I was utterly dreading discussing it with the owner – the meds are expensive enough, but add to that the monitoring necessary to make sure the meds are working, and it’s a significant expense. I know the owner well enough to know that while she could probably afford it, it would be a hardship. I felt SO BAD, it was ridiculous.

But then I pointed out the obvious to my obtuse self: I did not cause this disease. I do not make the drugs or testing expensive (my markup is very minimal on the more expensive drugs).  My job is to diagnose (which I did very efficiently) and provide recommendations for treatment.  That’s all i can do. It sounds so obvious now, in the moment it’s hard for me not to feel the burden of imparting crappy news.

A similar thing happened the other night when I saw a dog with increased respiratory rate on emergency. I did an exam and found a rather huge thyroid mass, which almost certainly would be a fairly malignant tumor. In the moments before I shared this news with the owners I almost felt panicky, literally as if I had caused it. But again: I did not cause this disease. All I can do is give my opinion, offer a referral if they would like a second opinion or to pursue surgery and chemotherapy, and offer my condolences.

I need to get over this; I need to keep myself, and my roll in my clients’ and patients’ lives in perspective: I’m just a piece of the puzzle, and I can only do so much.

I was in the hospital getting ready to have my boy for pretty much a full day before things got more exciting. I was induced around 7am, and didn’t really notice any change until about noon, and no significant pain until 4-5 or so. At some point during this time, I sent my farmer out to run a few errands. According to hospital protocol I wasn’t supposed to eat, so I needed some illicit snacks, and maybe a movie or two.

I’m sure he brought back some sort of food, though I don’t remember what. What I do remember is that somehow on his errand running he found some fake teeth – little rubber teeth that looked all rotted and malformed, that you could put in your mouth to cover your own normal teeth. Throughout the early stages of labor he would intermittently pop them in, start drooling and snorting and asking me if I had any caramels. You had to be there, but it was so silly and random and distracting, it was hilarious.

We still have those teeth kicking around the house and will pull them out and laugh about caramels. Perhaps I have a slight visceral reaction remembering that time, but still.

Anytime I think about how fantastic my husband is (is it weird or just lucky that I spend a lot of time thinking about how great he is?) this story comes to mind. It’s a lucky girl whose husband can make her laugh during childbirth.

Fit Bit: The Good, The Bad, The Ugly and The Obvious

(one of my biggest struggles with this blog is that it’s so undefined in scope. It was a vet school blog…so do you really want to hear about my attempts to get healthier? Do you want to know about my son? My vet clinic? My life as a farmer’s wife? So I’m trying to not overthink it and just write about whatever inspires me. Hope that works for you!)

I have been a happy FitBit wearer for a solid 3-4 weeks now, and truly, I love it. We’ve had some getting used to each other to do, we’ve come to accept each other’s strengths and weaknesses, and it’s possible I get a little panicky when I realize that I’ve left it behind (more on that later).

The Good: It is rather motivating. If I get to midday and see that I’ve only logged 3000 or so steps, I know that I need to get out for a walk or to start pacing or SOMETHING. Also, the FitBit.com interface that breaks down my day is positively fascinating. It will graph out over which times during each day I took the most steps, burned the most calories, etc. I also LOVE getting the extra calories credit in MyFitnessPal, though I’ve been rather crappy about actually using MyFitnessPal lately.

The Bad: It’s not a mind reader. Yesterday, in a fit of motivation I did a Jillian Michael’s 30-day-shred workout followed by a 20 minute Kettle Bell workout. Both workouts are video based and had me sweating and panting like a fool, but at the end of them, FitBit had logged about 100 steps and 150 calories burned.  And though it knows that I went up and down the stairs at home 4000 times yesterday, it doesn’t know that half the time I’m carrying a 26lb toddler. I’m not sure how it calculates calories burned – it’s not totally a function of the steps taken because there are days where my steps are low and my calories high, but it clearly can’t pick much up when it comes to jumping-in-place type workouts. And you know, I don’t wear it in the shower, so those minutes of aggressively washing my hair go unnoticed.

The Ugly: I’m kind of obsessed. Like I said, I don’t wear it in the shower. But I wish I could. And when I realize that I’ve just walked from one end of the house to the other without wearing it, I get a little panicky. Also, that FitBit.com interface breaks down your day into how much time was spent “Very Active”, “Fairly Active”, “Lightly Active” and “Sedentary”, and HOLY CRAP are those numbers alarming. On an active day, I’m sedentary for 16-18 hours!! Crazy, and kind of depressing.

The Obvious: I was pleased as punch to find out that logging 10000 steps a day is not a difficult chore for me. I do it without trying about 50% of the time. Since this was a pre-set goal, initially I thought “yay! I’m super active and healthy!”. But the cold hard truth is that I’ve really been “trying” to lose weight for at least 6 months (more like 6 years, but I did Couch-to-5K last summer and really, truly started in earnest then. And yet, my weight has not fluctuated up OR down by one tiny pound. And so it doesn’t matter how active I AM, it matters just that a. I am not active ENOUGH and b. I eat too much. And until I change that, I’ll change nothing else. Duh.

 

FitBit!

I have a long and boring past with my efforts to lose weight and get in shape that is marked by nothing more interesting than an inability for my motivation to hang on for more than about 3 days. So when my sister-in-law told me about how helpful her fitbit was in keeping her motivated and on track in general, I had to know more. What was this miraculous little object?

Turns out it is just a little tracker that you wear all day and it keeps track of how many steps you’ve taken, miles you’ve walked and calories you’ve burned (the more advanced version also tracks stairs and sleep). This in and of itself is not that exciting, but here’s the great part: it can sync automatically to MyFitnessPal!

Okay, so step back – myfitness pal is an AMAZING app that works very much like Weight Watchers, but without the annoying points. It is free, too! You track what you’ve eaten, water you have drank, and how much exercise you have done, and it basically tells you if you are going to lose weight or not. The problem with the app by itself is that it is fairly restricting: according to my goals, my calorie intake is 1360 calories/day, which is very hard for me to do. Oftentimes I’ll get to the end of the day and have 300 calories left for the day, and think “that’s ridiculous!”, and then eat 7 cookies on top of my nice healthy dinner. Clearly, this is the wrong thinking, I get that. Because if I have worked out and burned say 500 calories, suddenly the eating is not so restristricted.

So the fitbit is special because it automatically syncs to MyFitnessPal, and so that you can basically get credit for all the calories that you burn as you go about your day! Also, as my SIL said, if you get to the end of the day and see you’ve only walked say 3000 steps, it really motivates you to just get on the treadmill and do a little extra. Maybe not a 10 mile run, but a 2 mile walk. Or park in the far-away parking spot. Or, if you’re tired, to not eat that cupcake.

So I ordered one immediately and have been driving my farmer NUTS as I anxiously awaited its arrival all week last week. Even though I ordered it on Monday. Anyway, today it is HERE! And I’m super excited. Except for when I realized it won’t sync to either my phone or our tablet. Which means I have to wait until tonight to set it up on our computer.

Of course, when it comes to health and fitness, everything is fun and exciting the first day. But hopefully this will stick. I’m thrilled to report that I have already walked 642 steps today! So fun!