Thursday, March 15, 2012

I can finally get some sleep

Cats and dogs eat crazy things, and those crazy things can occasionally get stuck somewhere in the middle.  When this happens, we call it a Foreign Body Obstruction (FBO) and they can be pretty simple to remove or a total disaster.  If the foreign object hasn't been in there for very long and it is visible on an xray, that usually results in a good outcome, but if Fluffy isn't telling her owner just how sick she really is, and the item is not visible on an xray (metal, bone or some other dense object), then things can start running downhill quickly. 

This is Cookie, he looks like a good boy, right?

This is Cookie's story. What Cookie swallowed wasn't that big, but he isn't much of a complainer and didn't start to act like he was sick until about a week after eating a large bead from a child's jewelry making kit.  I have to imagine that most of the time, these things are swallowed by accident, I can just picture him playing with it, carrying it around in his mouth and then, GULP, down it went.  At first his owner wasn't worried,  she hadn't seen him swallow the bead. Eventually she brought him in and we were able to figure it out pretty quickly.  I didn't know what he had swallowed, but I knew that we were going to find something.  Well, that bead managed to get out of the stomach, but got stuck in the duodenum, right next to the pancreas.  Ugh, the pancreas is so sensitive, I don't even like to look at it.  Well, with it having been there for a week or so, that piece of duodenum was pretty grumpy.  If it is questionable whether or not a piece of intestine is going to survive, we just take out the whole section and put the good, healthy ends back together.  But in this case, I really wasn't willing to take out that section of duodenum because of its proximity to the pancreas unless it had already fallen apart, so I made an incision into the duodenum, took out the bead and closed it back up. I put in my usual "sleeper stitch", which is that last stitch that you put in when you are asking yourself or your assistant, "do these look like they are close enough together?" so that you can sleep knowing that the sutures were definitely not too far apart.  That didn't really work for getting sleep though, like its name suggests. 

I have a friend who is an amazing human cardio-thoracic surgeon, so as usual, I told him about the case and asked, as if he had a crystal ball, did he think that the duodenum would live.  His answer, of course, was that he didn't know, but he would have made the same decision and in fact used to go running from any procedure involving the duodenum and pancreas as a general surgery resident.  That made me feel better, but not better enough to sleep well for about 10 days.

It was finally at that 12th day when Cookie came in to have his sutures removed that I had a good night sleep.  Any problems from here on out couldn't be a direct result of my surgery.  I also let my kids off the hook during bedtime prayers, they could pray for whoever they wanted instead of saying "God, please let Cookie get better". 

This is the bead that Cookie swallowed.

Cookie is back to his playful self, as lovable as ever.  Now his owners are probably the ones losing sleep trying to keep their house Cookie proofed.  That is not going to be an easy job!

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