Day 112 - Dirty Knees

I'm very glad my mom taught me about the Spray-n-Wash Stain Stick.  In a profession like mine, it really is the difference between being able to keep clothes around and flicking them with a Bic.  (That's a Baxter Black reference that likely only Dr. B will recognize but everyone should read HERE.)  :) 

These are my jeans that I was wearing this past Friday night during my sheep c-section.  Sure, I had on thick insulated canvas coveralls.  But blood travels through coveralls.  The pictured jeans are coated in the magical goodness that comes from the Stain Stick and are in the wash right now.

Our friend, Kyle who was the photographer that night was a great sport about all the blood and mess.  On the way home from the C-section, I recounted for him a story of severe blood-mess from my first year of practice.  I think I should write it down - and that's exactly what this blog is for.  :)  I remember the morning well.....

  Sunday morning.  December 15th, 2002.  4am.  'Beep. Beep. Beep. Beep.'

It was cold.  I don't remember how cold - but cold.  A pager going off at 4am on a Sunday morning always means two things:  1) it's a dairy farmer (no one else is ever up that early) and 2) it's bad (they don't call on Sunday mornings unless it's a life or death situation.)

I had only been in practice for 5 months at that point and was still in the phase of my career where I threw up pretty much anytime my pager went off.  That started to fade away after the 6 month mark, thankfully.  :)  So, after answering the page, calling the farmer to find out what the problem was, throwing up and getting dressed - I headed out just a few miles down the road.

It was o'dark thirty at this point (very early and still dark) and I drove into a pasture to find a cow that had recently given birth and was now experiencing a prolapsed uterus.  This is a pretty life-threatening condition where the uterus basically turns inside-out due to low blood calcium levels.  If not corrected the cow can die due to blood loss, infection, shock, or cardiac arrest - or any combination there-of.

I made it through my entire vet school career without having ever seen one.  I saw TWO on the same day during my working interview here that summer.  Had not seen one since.  

But I knew what to do!!  She was down and could not get up due to her weakness, so I did not need to do an epidural.  I just needed to 'stuff it back in.'  (My vet school professor called them 'stuffbacks.')  So I did!  Or, rather, I tried. 

I knelt on the ground behind the cow, pulled the uterus up onto my lap, and cleaned it off. (Just so you can get a mental picture, this uterus has just delivered a 100lb calf. It is a bloody bag of muscle that weighs 40-50lbs and is 2-3 feet in length.) I then began to push it back in.  I pushed and pushed and pushed and pushed.  I layed down on the ground and pushed.  I had the farmer help me push.  We pushed and pushed and pushed and grunted and pushed until we just couldn't push anymore.  

At 6am I gave up and called Dr. Bowman to help me.  

I continued to try and push it back in until he arrived.  I will never ever forget what he said to me as he stepped out of the truck.  

"DOCTOR!!!!  You are trying to push a uterus into a BLOATED cow UPHILL! That is NEVER going to work!"  

My internal thought process reaction: 'Oh.  She IS bloated.  And I AM pushing uphill.  Well, that's pretty stupid.  Why didn't I notice that?!?'

My super intense focus on getting the job-at-hand done blinded me to giving myself every opportunity to succeed.  This is an important life lesson I have tried to apply to every other problem I have since set out to tackle.  THINK first.  THEN dive in.  :)

With his help (and the help of a 4-wheeler) we sat her up on her chest (she had been laying on her side) and she began to burp and belch and let off that gas in her stomach that had made her bloated. (Cows can't burp laying on their side.) We then spun her around so she was facing downhill, and we pulled her legs out behind her in order to tilt her pelvis forward. 

Dr. B then said to me "NOW try pushing it back in."  I was completely and utterly exhausted and it did not take him long to see that.  He was very kind and took over for me and replaced the uterus into the cow.  I started an IV to give her some calcium and other nutrients her body needed.  

It was then, while standing there holding the bottle of fluids above the cow, that I realized it was cold outside. VERY cold standing on the top of this hill at dawn.  Next, I realized that I was wet.  I was soaked through all of my many layers of clothes in blood.  Blood and just general ground snow/frost/moisture wetness.  Finally, my adrenaline began to wear off -  and I began to shake.  Violently. 

Cold + Wet + Adrenaline Crash + low blood sugar  = Leslie shaking like she's having a seizure.  

I remember Dr. B saying 'hold on just a few more minutes, doctor - then you can go and get warm.'  

We cleaned up, admired the beautiful winter morning sunrise, and then got in our trucks to go home.  It was only a 5 minute drive back to my apartment and soon I was standing at my front door facing a dilemma. 

I was absolutely soaked/drenched/downright BATHED in blood.  It was literally dripping from my clothing.

I lived in a apartment that I was renting.  It had WHITE carpet throughout.  My shower was waiting for me upstairs.

I lived in a townhouse apartment at the top of a hill.  If you were standing in my living room looking out through the big picture window you would just see a parking lot and a hill.  No other apartments.  

I always kept my blinds up and my curtains open - I enjoyed the light and privacy was never really a concern.  Until now. 

There was a very small square of vinyl flooring just inside my front door.  I decided that I just had to strip down right there on that vinyl in order to keep from getting blood on the carpet.  It was 7am on a Sunday morning - I was pretty confident (and very hopeful) that no one would walk past the window.  I was in full view.  

The blood had soaked down into my boots, even - so even the bottom of my feet were bloody.  I found a non-bloody spot on the back of one of my shirts to wipe my feet off on before I ran up the stairs buck-naked and covered in blood.  As far as I know, no one saw me.  If they did, I'm thankful they never approached me about it.  

I stood in the shower and it looked like something from a horror movie.  It was awesome.  While scrubbing myself clean and soaking in the heat of hot water, I heard a most disturbing sound:  'Beep. Beep. Beep. Beep.'

7am on a Sunday.  Are you kidding me???

"This can't be good. "

It was a different dairy farm with 2 DA's.  (A DA is a cow with a twisted stomach that I have to do surgery on to repair.)  I told the farmer that I would be there soon but I needed to eat first.  

Which I did - right after I threw up again.  :)

Is it any wonder I lost 10lbs my first 6 months in practice???

After the two DA's, my pager went off AGAIN.  Pretty sure I threw up again, too.  I can't remember what that 3rd call was, but it obviously wan't too traumatic since I don't remember it.  Or maybe I was just too deliriously tired at the end of the day to lock it in to memory. 

To date, that has been my hardest day on-call.   I do not look forward to the day that tops it.  At all.

As for the jeans in the picture, they are probably clean by now - and the magical Stain Stick will have made them as good as new.  :)

The cow with the prolapsed uterus did not get up for several days - but eventually did.  Yay!