What’s In A Name?

ike-cone-of-uncertainty

 

Sometimes I think of the way we practice medicine is sort of like fishing with a net.  Dog or cat comes in sick,  we often cast this big, wide net of diagnostic tests to see what kind of disease it’s got.  Could be anything from cancer to it ate a bug, but by running tests and stuff we can figure it out.

Conversely, I feel like human doctors often “fish” with harpoons.  You come in sick, odds are it’s a cold, but sometimes it’s someting worse.   Human docs seem to be trained to play the odds and cast the harpoon at the most common thing, the cold.  Occasionally (?) they miss, and it’s really something awful, and then you hear the horror stories of people who are sick for years, and multiple docs can’t figure it out, then the right doctor runs the right test, and they finally figure it out, etc etc…

This is totally subjective, but I think that sometimes, we vets have better luck figuring things out using the net.  I just hear all these tales of people waiting for weeks for a diagnosis, when a lot of times, we can figure things out within a few days.  (Often there’s not much we can do about it, but at least we can tell you what’s wrong)

Anyways, this gets me to the Weatherman’s “net”.  The folks at the National Hurricane Center call it “The Cone of Uncertainty”.  I think it’s kind of funny, because, if you look at the picture, the “Cone”, comprises pretty much the whole coastline along the Gulf of Mexico.  That’s a pretty good margin of error.  It’s like me handing the sick dog owner the book:  The Clinical Veterinary Advisor and telling them, your dog could have one of these diseases. 

Furthermore, and I know I’m waaaay overthinking things here, but that’s what I do…it’s what I liiiiiive for (to quote Ursula the Sea Witch from The Little Mermaid)…I often feel like my whole life is a cone of uncertainty.  If I let myself, I can literally drown in a sea of it…Will my kids turn out ok, or will they be psycho drug dealers? Will I live to see them grow up? Should I stay a vet or become a teacher?  My kid has a nose bleed, is it just a nose bleed or is it cancer? Is daycare screwing the kids up? Am I selfish to work and not stay home with the kids? Paper or plastic? Save the trees or the oceans? walk or drive?  Do you want ketchup with that?  But, I read once that “worrying is about as effective as trying to solve an algebra problem by chewing gum”, so I try to bury that stuff and silence the whatifs.

I feel like I’m constantly walking on the edge of a precipice, and things could go terribly wrong in the blink of an eye.   SO, here is me officially declaring:  I am wholeheartedly, profoundly, and utterly grateful for what I have and who I am right now. 

We all live in a cone of uncertainty, and I guess it’s what we do with it that matters….

6 thoughts on “What’s In A Name?

  1. I just read this after following the blog for awhile now. Please, please do not leave medicine for teaching. There are few doctors with knowledge, compassion, sound reasoning and an open mind in veterinary medicine today.

    Your willingness to always listen to what others might consider “wacky” ideas and potential solutions to medical/emotional problems in pets is very rare and very needed.

    I will always come back to you for guidance with serious issues because I’m just not sure I trust anyone else with critical life and death situations.

    The one regret I have now is that you aren’t also a “farm” vet and do house calls.

    Your talent with people and animals alike is too much to turn away from.

    1. Thanks for the kind words! One of the things I like about you is your ability to bring alternative and maybe “wacky” things to the table. I love that there are things “out there” that I don’t know about that could help and am always willing to make sure it won’t hurt to try. I love the relationship you have with your dogs that allows us to have those heart felt, life or death discussions.

  2. Whew I have the same issue with controlling my life. the Uncertainty can make me fearful and seems to get worse when I get depressed.

    Depression and me seem to always meet up…anywho perhaps it is faith that helps.
    I am not sure, I dont really have faith in anything. I have searched for answers and spent years searching for answers to Uncertainty and how to live with it.

    My wife has allot of faith and that really seems to help her deal with life.

    There are many tools out there, live in the now, one day at a time, prayer, belief in god, or buddism. A support system…all seem to work if your apt to try them….but if you stop all of the fear of the Uncertainty seems to come crashing back.

    I guess I am with you, out of site out of mind, dont think, just do.

  3. Have you ever treated a “Swimmer Puppy” ? IF so, what did you do to get it to stop spreading their front legs out?

  4. I just stumbled across your blog which I enjoyed a great deal. You speak in “normal language” instead of “vetspeak” which I find refreshing. I was looking for more information on Cushings Disease and there you were! I have an 10 year old Yorkie/Silky (not sure which, all my dogs are abuse rescues) who I have had since she was 7 months old. She was diagnosed with Cushings about 4.5 years ago. She was 19 pounds at the time. We treated her with Trilostane (at one time up to 45 mg) and then one day she found her way into an Addisonian crisis and almost died. IV fluids, lots of stuff. When she was no longer dehydrated, my vet at the time recommended that we leave her off the meds for awhile and then start her on small doses all over again. Lots more expensive testing. She is now on 10 mg and it makes her rear legs (in which there is some weakness but good extension) tremble when at rest. My vet relocated – I had her records transferred – and the new vet found her with a slight heart murmur today. She was supposed to have a dental but the vet wants to do an e-xray. I refused. She is eating normally, drinking normal amounts of water and not peeing in the house. She now weighs 8.5 pounds and the vet said she has very early signs of kidney disease in one kidney but the other one is normal. Would I be awful if I let her continue on until I see signs of a problem? Will I be taking a bad chance if I let her go ahead with the dental? The teeth are bad and I’m afraid that could also affect her heart. Just curious about your opinion. Thanks. I have become a loyal fan!

    1. Thanks for your comment. I actually turned off comments on that article because I received so many queries from people regarding their own pets. It’s illegal for me to give veterinary advice without having examined the patient. In your case, yes, I think it’s worth waiting on re-starting Trilostane until your dog is showing symptoms. Regarding the dental, that needs to be a frank discussion with your vet. Anesthesia is always risky. I’ll tell you, based on my experience with my dog Katelin, in hindsight, I wish I had taken the chance and continued cleaning her teeth after her kidney failure diagnosis. When she finally passed, her teeth were rotting out of her head & I’m sure that caused her unnecessary pain and discomfort. Granted, I probably would have taken her to a veterinary dentist, who specializes in high risk anesthesia.

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