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roller-coaster week
The last few days have undoubtedly added gray hairs. Oof.
When the vet called earlier, she reported that their ultrasound person thought it was a problem with the gallbladder (blockage), which would be easily fixable. So off to the surgeon I went.
He said that based on the ultrasound pictures he didn't think that was likely, and that we needed a biopsy to figure out what's going on in there. There are two ways to do that, one involving a needle guided by ultrasound and the other involving surgery. (The first vet had said that while they were in there looking at the gallbladder, they could also do biopsies.) Surgery involves more risk (though still low, he said; both processes would involve anesthesia, so that's a wash), but they'd be able to get better samples to evaluate. And, of course, if it really was the gallbladder, that would require surgery anyway. So I said do the surgery. I consider time to be of the essence given how long Erik has been sick already.
Somewhere in there, he shared his theory: lymphoma. Ack. I said "but wouldn't they have found tumors?" and he said lymphoma is special that way; it usually doesn't cluster into visible tumors. Lovely. So a few hours after I'd shaken the fear that my cat had cancer, it was back again.
During most of our discussion (after the surgeon had given Erik an exam), Erik was curled up napping on my coat. He was a little more active today than on Tuesday, and he was up to 7 pounds and a bit (so still down a pound), but for a normal vet visit he would never settle down like that. (Aside: everyone who handled him today commented on how affectionate and gentle he is.)
So off Erik went to surgery, and I went home. The surgeon called a couple hours later and said something like "damn, the ultrasound person had it nailed!". His bile duct was blocked, and the surgeon opened that up. (Actually, what he did was install bigger plumbing between the gallbladder and the output stream, so if the regular connection gets plugged again it's not the only one. He didn't take out the gallbladder; no need, he said. So I guess my cat got a bypass of sorts.)
The surgeon said there's a quick, medium-accurate test they can do for lymphoma, and that came back negative. We won't know the results of the real biopsies until Monday or Tuesday. It's possible that the blockage fully explains the problem; the surgeon said that's consistent with the blood tests and Erik's symptoms. But it could be something more, and Erik does have a history of elevated liver enzymes, so best to check. (And, having seen the itemized cost estimate, the tests are a small part compared to the surgery itself. So economizing there makes no sense.)
We're not sure yet when Erik gets to come home. Possibly tomorrow, but probably not.
Two meta-observations:
1. The surgeon, who I'd never met before, treated me like an intelligent person from the get-go, not dumbing things down or omitting details. The animal hospital is not part of my vet's practice, so they wouldn't have any information about me (or Erik) other than the test results that were sent over today. Thus, I conclude that this is his default way of interacting with patients (well, patients' owners). Lots of people-doctors don't do this.
2. The animal hospital (this is the place that's open at night and on weekends for emergencies) wasn't too hard to find, but the return trip is something I never want to do after dark again. Specifically, the interchange from Route 8 to Route 28 to the Highland Park Bridge contained awkward bits and surprises. Better signage would have helped some. And I'm glad it was rush hour, where traffic is heavy enough that it's assumed that people will force their way into the lanes they want. Dani has graciously agreed to take me if Erik needs to be picked up after dark.
Edited to add: thank you everyone for your good wishes over the last couple days! (I meant to include this before and blew it.)
When the vet called earlier, she reported that their ultrasound person thought it was a problem with the gallbladder (blockage), which would be easily fixable. So off to the surgeon I went.
He said that based on the ultrasound pictures he didn't think that was likely, and that we needed a biopsy to figure out what's going on in there. There are two ways to do that, one involving a needle guided by ultrasound and the other involving surgery. (The first vet had said that while they were in there looking at the gallbladder, they could also do biopsies.) Surgery involves more risk (though still low, he said; both processes would involve anesthesia, so that's a wash), but they'd be able to get better samples to evaluate. And, of course, if it really was the gallbladder, that would require surgery anyway. So I said do the surgery. I consider time to be of the essence given how long Erik has been sick already.
Somewhere in there, he shared his theory: lymphoma. Ack. I said "but wouldn't they have found tumors?" and he said lymphoma is special that way; it usually doesn't cluster into visible tumors. Lovely. So a few hours after I'd shaken the fear that my cat had cancer, it was back again.
During most of our discussion (after the surgeon had given Erik an exam), Erik was curled up napping on my coat. He was a little more active today than on Tuesday, and he was up to 7 pounds and a bit (so still down a pound), but for a normal vet visit he would never settle down like that. (Aside: everyone who handled him today commented on how affectionate and gentle he is.)
So off Erik went to surgery, and I went home. The surgeon called a couple hours later and said something like "damn, the ultrasound person had it nailed!". His bile duct was blocked, and the surgeon opened that up. (Actually, what he did was install bigger plumbing between the gallbladder and the output stream, so if the regular connection gets plugged again it's not the only one. He didn't take out the gallbladder; no need, he said. So I guess my cat got a bypass of sorts.)
The surgeon said there's a quick, medium-accurate test they can do for lymphoma, and that came back negative. We won't know the results of the real biopsies until Monday or Tuesday. It's possible that the blockage fully explains the problem; the surgeon said that's consistent with the blood tests and Erik's symptoms. But it could be something more, and Erik does have a history of elevated liver enzymes, so best to check. (And, having seen the itemized cost estimate, the tests are a small part compared to the surgery itself. So economizing there makes no sense.)
We're not sure yet when Erik gets to come home. Possibly tomorrow, but probably not.
Two meta-observations:
1. The surgeon, who I'd never met before, treated me like an intelligent person from the get-go, not dumbing things down or omitting details. The animal hospital is not part of my vet's practice, so they wouldn't have any information about me (or Erik) other than the test results that were sent over today. Thus, I conclude that this is his default way of interacting with patients (well, patients' owners). Lots of people-doctors don't do this.
2. The animal hospital (this is the place that's open at night and on weekends for emergencies) wasn't too hard to find, but the return trip is something I never want to do after dark again. Specifically, the interchange from Route 8 to Route 28 to the Highland Park Bridge contained awkward bits and surprises. Better signage would have helped some. And I'm glad it was rush hour, where traffic is heavy enough that it's assumed that people will force their way into the lanes they want. Dani has graciously agreed to take me if Erik needs to be picked up after dark.
Edited to add: thank you everyone for your good wishes over the last couple days! (I meant to include this before and blew it.)
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And, yeah. I like doctors like that. Somehow I keep getting lucky that way.
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I hope Erik continues to recover well. And if it's after dark and Dani isn't available to go out to the vet, please call me. I used to work in that neck of the woods and can still navigate it.
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I found myself having difficulty with the "oh oops, I need to be over there now" aspect of those interchanges. I'm not sure, in retrospect, if it's that the signs weren't early enough (my impression) or if they didn't actually have the right content. I think the Highland Park Bridge was mentioned only late in the series, and that I was following signs for 28N and then suddently had to be making a turn across traffic. Or something like that. At night, it's really hard to determine distance of the headlights behind me, so knowing when it's safe to make a lane change is hard. It's not bad on interstates and on roads I know, of course; those are both pretty predictable. I think my problem is "weird roads at night".
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Finger and paws crossed Chez Nous....
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As for gray hairs, I think mine are outnumbering the dark ones. :-)
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I lived for five years in Aspinwall, and the whole Rt. 28/Highland Park Bridge interchange is embedded in my hindbrain by now, but it is an awfully... optimistic traffic design. Coming around from 28N onto the bridge, you have to merge quickly into another lane while half the people coming from 28S merge into your lane so they can exit into Aspinwall. There are always fresh tire tracks running up the concrete barriers; it's a popular spot to go smash.
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"Optimistic" is an excellent description for that interchange. Thanks. :-)
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I'm glad to hear Erik is doing better. Vandal still hasn't gained back the weight he lost when he was sick (I think we need to use the Vitagravy stuff more).
S
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