Monday, February 17, 2014
Wednesday, February 12, 2014
The importance of communication!
Joan Kleynhans
So true: "Vets may not be describing the value of what goes on in an exam," says veterinarian Karen Felsted of Felsted Veterinary Consulting in Dallas.
Even as a dog walks into the exam room, most vets are observing gait, looking for undiagnosed arthritis or neurological issues. When they pet the pup or kitty, they are feeling for lumps and bumps, which may suggest thyroid disease or other conditions.
But about 30% of pet owners don't understand their pet is more likely to get sick without an annual exam, according to the 2011 Bayer Veterinary Care Usage Study."
Like · · Share · Yesterday at 8:04am · .
yup. I did a whole vaccination appointment recently, including full exam. At the end of it the client said "aren't you going to give him a check up?. Facepalm.
- Joan Kleynhans They have said to me, so aren't you going to vaccinate him, as I am standing there pleased as punch that I can vaccinate a pet (sometimes), without them (the pet) even noticing. They say you should talk your way through it - as in " OK, so while I am pretending to pet you I am actually feeling for lumps and bumps on your skin. I have already noticed that you are walking normally as you came in, but let us feel your joints as well. I can see you are listening to me and following me with your bright eyes, so no obvious problems there but let us pull out the otoscope and opthalmoscope and have a better look anyway.Those too little goodies really impress them! Ah, great your temp is 38.5 which is perfectly normal, and your anal and tail pinch reflex work just fine! Or just run through a simple checklist - a cute card with pictures to both remind the vet and reassure the owner!
- Yesterday at 8:15am · Like · 3
I guess there are always some folk who will be über grateful and those that moan and winge and don't appreciate your skills.
- Yesterday at 8:21am · Unlike · 2
I swear I did it like you said today Joan Kleynhans, I think clients were wondering why I was babbling non-stop. I usually do tend to describe what I am doing but not in such detail - I think it worked though, and some of the comments etc sparked questions. Funny after so many years you can put s simple idea like this in action and see a change. Thanks!
Friday, February 7, 2014
You get those moments...
Written by John Birmingham in "He died with a felafel in his hand" - a weird story I found in a strange place and never completed:
"You get those moments ... and you wonder what forces delivered you to this place at this time. It's as though your life travels through this complex grid where stuff happens ....and a little point of light plots the events on the grid. All the points are woven together by this weird mathematical program that determines the course of your life and the future - each little moment, each point of light, driven along by the falling numbers of some impenetrable logarithm. "
"You get those moments ... and you wonder what forces delivered you to this place at this time. It's as though your life travels through this complex grid where stuff happens ....and a little point of light plots the events on the grid. All the points are woven together by this weird mathematical program that determines the course of your life and the future - each little moment, each point of light, driven along by the falling numbers of some impenetrable logarithm. "
Saturday, February 1, 2014
Town of Hope or Town of Despair?
I am rapidly running out of days before my trip to Australia as my to do list gets longer. At the same time, something major seems to be happening every day! Nearly two weeks ago my adorable first granddaughter was born. That took care of that week!
This week my very elderly dog, Diesel ( Labrador cross Weimaraner) developed severe vestibular syndrome with vomiting and circling and loss of balance for the second time in a few months. As she was also getting hard of hearing, had cataracts, and arthritis which was quite severe at times, I made the hard decision to put her to sleep. I am sad, but accept that it was appropriate and necessary. When the rains start, I will plant an indigenous tree on her grave. I also took my daughter's little Maltese type mutt, which she saved from certain death on the N2 to a groomer. I drove 20 km over the mountain, dropped her off and went shopping at the nearby mall. Or at least, that was the plan! I was barely there before the groomer phoned to say that they could not handle this 4.5 kg man-eating monster! I collected Maddie, placed her on the car seat, and as I drove off, reached out to give her a sympathetic pat. Her response was a vicious bite! Luckily she has very blunt teeth, so only caused a bruise, but unpleasant all the same! On Tuesday (it feels like weeks ago - not just 4 days) I took her to the vet clinic where I sedated and clipped her. In spite of deep sedation, she managed to get about 5 painful bites in! Yesterday my son-in-law's mother phoned. Daughter and son-in-law's big dog was very ill. I rushed over to find her extremely feverish and depressed. I am not working at the moment and it was after hours. It was a bit of a struggle to find a vet. Thank you so much for being there when we needed you, Dr. +Alex Rowe Then we had to get this nearly 60 kg Irish Wolfhound cross into a SUV. A challenge for three grandparents! Luckily my other son-in-law is a big strong guy and could be called upon to help. That took care of most of last night and today, as I spent a lot of time in the vet hospital helping to take care of her and collect first a blood donor, then blood, and start a blood transfusion. She only started to show some improvement by late afternoon today.
In the midst of all my personal drama, while driving earlier this week, I heard a radio interview with Mr. +Stan Wallace the Municipal Manager for Theewaterskloof - the region in which my home town, Grabouw, falls. He was responding to the fact that the community was most distressed because a wall at the local sports-field had fallen over, injuring 5 children. He said that Grabouw was the poorest municipality in the Western Cape, if not the country. There are limited means and sports-fields are not a priority. As I drove I took in the vast squatter camps that have sprung up between the town and the N2 (National Road to Cape Town) in the past decade or so. About two years ago there was significant unrest because the schools could not accommodate all the newly arrived pupils. Early last year there were protests over farm wages. The vast majority are unemployed. The little work that the district (fruit picking and packing) offers, is seasonal. Other than some forestry, which is being scaled back as the government has decided that it is unprofitable, there is no industry besides farming.
Why then do the people come? I believe it is because Grabouw is the gateway to Cape Town for those coming from even more impoverished and under serviced areas in the Eastern Cape, elsewhere in South Africa and as far afield as Zimbabwe, Malawi and Somalia.
For the well heeled, it is a magnificent area with scenic beauty, fine restaurants, excellent wines and superb outdoor recreational facilities. For the poor, the summers are too hot, and the winters too cold, wet and miserable. For both groups, the proximity to Cape Town is a plus.
However, the squatter camps keep growing. Public transport takes two hours to Cape Town and costs nearly half a labourer's daily wage. Poverty and boredom increase the crime rate. The municipality does not have the means to provide services for all or even to maintain existing infrastructure in good condition. Mr. Wallace says that less than 45% of households in Grabouw pay rates and taxes, and even amongst those, many are poor payers. He and his team have the will to do as much as possible to advance the town and the region. He welcomes initiative and projects from the private sector. He acknowledges that the municipal funds are woefully inadequate.
On Thursday afternoon I headed to Cape Town to attend Standard Bank's WEF Davos feedback session with+ Alec Hogg. I allowed more than an hour for a trip that should take 45 minutes. It took way more than an hour due to an accident near Mew Way. I was disappointed to arrive late. The talk was fascinating and Mr Hogg talked of a brave new world with creation of money, exponential growth of technology, 3D printing, investments, low hanging fruit in Africa, the potential of fracking to solve the energy crisis and other things that matter! As fascinated as I was, I could not help thinking how many good people in Grabouw, who are here searching for better opportunities after all, live in a world so very different to the attendees of the Davos Forum and the Standard Bank talk.
I mentioned it to Mr Hogg, who suggested I blog about the local problems and challenges and see where it leads. Perhaps there is hope and help out there for the people of Grabouw. So for those of you who follow my blog because of its veterinary nature - keep reading! I will always be a vet at heart. Animal Welfare is as much an issue as people welfare in poor unstable communities. We shall get to that as well in due course.
Driving home, I saw a scrawny dog near the centre barrier of the three lane N2, searching for scraps, with cars in the fast lane whizzing past. There was just no way I could stop to try and save him. Chances are he is traffic savvy and semi-feral, and even if I could stop safely, that may have caused him to flee into the traffic and get killed. Near the turn-off to the airport, there was a horse grazing on the grass verge of the highway.
South Africa - land of such promise and such despair.
This week my very elderly dog, Diesel ( Labrador cross Weimaraner) developed severe vestibular syndrome with vomiting and circling and loss of balance for the second time in a few months. As she was also getting hard of hearing, had cataracts, and arthritis which was quite severe at times, I made the hard decision to put her to sleep. I am sad, but accept that it was appropriate and necessary. When the rains start, I will plant an indigenous tree on her grave. I also took my daughter's little Maltese type mutt, which she saved from certain death on the N2 to a groomer. I drove 20 km over the mountain, dropped her off and went shopping at the nearby mall. Or at least, that was the plan! I was barely there before the groomer phoned to say that they could not handle this 4.5 kg man-eating monster! I collected Maddie, placed her on the car seat, and as I drove off, reached out to give her a sympathetic pat. Her response was a vicious bite! Luckily she has very blunt teeth, so only caused a bruise, but unpleasant all the same! On Tuesday (it feels like weeks ago - not just 4 days) I took her to the vet clinic where I sedated and clipped her. In spite of deep sedation, she managed to get about 5 painful bites in! Yesterday my son-in-law's mother phoned. Daughter and son-in-law's big dog was very ill. I rushed over to find her extremely feverish and depressed. I am not working at the moment and it was after hours. It was a bit of a struggle to find a vet. Thank you so much for being there when we needed you, Dr. +Alex Rowe Then we had to get this nearly 60 kg Irish Wolfhound cross into a SUV. A challenge for three grandparents! Luckily my other son-in-law is a big strong guy and could be called upon to help. That took care of most of last night and today, as I spent a lot of time in the vet hospital helping to take care of her and collect first a blood donor, then blood, and start a blood transfusion. She only started to show some improvement by late afternoon today.
In the midst of all my personal drama, while driving earlier this week, I heard a radio interview with Mr. +Stan Wallace the Municipal Manager for Theewaterskloof - the region in which my home town, Grabouw, falls. He was responding to the fact that the community was most distressed because a wall at the local sports-field had fallen over, injuring 5 children. He said that Grabouw was the poorest municipality in the Western Cape, if not the country. There are limited means and sports-fields are not a priority. As I drove I took in the vast squatter camps that have sprung up between the town and the N2 (National Road to Cape Town) in the past decade or so. About two years ago there was significant unrest because the schools could not accommodate all the newly arrived pupils. Early last year there were protests over farm wages. The vast majority are unemployed. The little work that the district (fruit picking and packing) offers, is seasonal. Other than some forestry, which is being scaled back as the government has decided that it is unprofitable, there is no industry besides farming.
Why then do the people come? I believe it is because Grabouw is the gateway to Cape Town for those coming from even more impoverished and under serviced areas in the Eastern Cape, elsewhere in South Africa and as far afield as Zimbabwe, Malawi and Somalia.
For the well heeled, it is a magnificent area with scenic beauty, fine restaurants, excellent wines and superb outdoor recreational facilities. For the poor, the summers are too hot, and the winters too cold, wet and miserable. For both groups, the proximity to Cape Town is a plus.
However, the squatter camps keep growing. Public transport takes two hours to Cape Town and costs nearly half a labourer's daily wage. Poverty and boredom increase the crime rate. The municipality does not have the means to provide services for all or even to maintain existing infrastructure in good condition. Mr. Wallace says that less than 45% of households in Grabouw pay rates and taxes, and even amongst those, many are poor payers. He and his team have the will to do as much as possible to advance the town and the region. He welcomes initiative and projects from the private sector. He acknowledges that the municipal funds are woefully inadequate.
On Thursday afternoon I headed to Cape Town to attend Standard Bank's WEF Davos feedback session with
I mentioned it to Mr Hogg, who suggested I blog about the local problems and challenges and see where it leads. Perhaps there is hope and help out there for the people of Grabouw. So for those of you who follow my blog because of its veterinary nature - keep reading! I will always be a vet at heart. Animal Welfare is as much an issue as people welfare in poor unstable communities. We shall get to that as well in due course.
Driving home, I saw a scrawny dog near the centre barrier of the three lane N2, searching for scraps, with cars in the fast lane whizzing past. There was just no way I could stop to try and save him. Chances are he is traffic savvy and semi-feral, and even if I could stop safely, that may have caused him to flee into the traffic and get killed. Near the turn-off to the airport, there was a horse grazing on the grass verge of the highway.
South Africa - land of such promise and such despair.
Snake D H Lawrence
D. H. Lawrence
Snake
A snake came to my water-trough
On a hot, hot day, and I in pyjamas for the heat,
To drink there.
In the deep, strange-scented shade of the great dark carob-tree
I came down the steps with my pitcher
And must wait, must stand and wait, for there he was at the trough before
me.
He reached down from a fissure in the earth-wall in the gloom
And trailed his yellow-brown slackness soft-bellied down, over the edge of
the stone trough
And rested his throat upon the stone bottom,
i o And where the water had dripped from the tap, in a small clearness,
He sipped with his straight mouth,
Softly drank through his straight gums, into his slack long body,
Silently.
Someone was before me at my water-trough,
And I, like a second comer, waiting.
He lifted his head from his drinking, as cattle do,
And looked at me vaguely, as drinking cattle do,
And flickered his two-forked tongue from his lips, and mused a moment,
And stooped and drank a little more,
Being earth-brown, earth-golden from the burning bowels of the earth
On the day of Sicilian July, with Etna smoking.
The voice of my education said to me
He must be killed,
For in Sicily the black, black snakes are innocent, the gold are venomous.
And voices in me said, If you were a man
You would take a stick and break him now, and finish him off.
But must I confess how I liked him,
How glad I was he had come like a guest in quiet, to drink at my water-trough
And depart peaceful, pacified, and thankless,
Into the burning bowels of this earth?
Was it cowardice, that I dared not kill him? Was it perversity, that I longed to talk to him? Was it humility, to feel so honoured?
I felt so honoured.
And yet those voices:
If you were not afraid, you would kill him!
And truly I was afraid, I was most afraid, But even so, honoured still more
That he should seek my hospitality
From out the dark door of the secret earth.
He drank enough
And lifted his head, dreamily, as one who has drunken,
And flickered his tongue like a forked night on the air, so black,
Seeming to lick his lips,
And looked around like a god, unseeing, into the air,
And slowly turned his head,
And slowly, very slowly, as if thrice adream,
Proceeded to draw his slow length curving round
And climb again the broken bank of my wall-face.
And as he put his head into that dreadful hole,
And as he slowly drew up, snake-easing his shoulders, and entered farther,
A sort of horror, a sort of protest against his withdrawing into that horrid black hole,
Deliberately going into the blackness, and slowly drawing himself after,
Overcame me now his back was turned.
I looked round, I put down my pitcher,
I picked up a clumsy log
And threw it at the water-trough with a clatter.
I think it did not hit him,
But suddenly that part of him that was left behind convulsed in undignified haste.
Writhed like lightning, and was gone
Into the black hole, the earth-lipped fissure in the wall-front,
At which, in the intense still noon, I stared with fascination.
And immediately I regretted it.
I thought how paltry, how vulgar, what a mean act!
I despised myself and the voices of my accursed human education.
And I thought of the albatross
And I wished he would come back, my snake.
For he seemed to me again like a king,
Like a king in exile, uncrowned in the underworld,
Now due to be crowned again.
And so, I missed my chance with one of the lords
Of life.
And I have something to expiate:
A pettiness.
Taormina, 19
Tonight, just after sunset, I was strolling around my garden, when suddenly the dogs started barking furiously at a vine growing against the porch. Coming closer, I heard a mouse squeak. I pulled away a low hanging branch to save the mouse, when I saw - not a mouse - but a snake. A squeaking snake you say - no way! Exactly what I thought! On closer inspection, I saw that the snake had his mouth, which was rather small, firmly clamped around a frog, which was rather big and squeaking for dear life. I ran to get my camera. Sorry frog - it is that circle of life thing and it was not my turn. However when I returned, the frog had been swallowed and the snake slowly made its way into a crack under the floor of the porch.
I think, I hope, that it is a harmless house snake! Any herpetologists out there that can identify this snake from this rather less than satisfactory photo?
Joan
Grabouw
Thursday, January 30, 2014
My worst job ever!
Many years ago I moved to Australia for the first time. I responded to an add in the AVA Journal and was offered a job in a rural area. I was foolish enough to accept at face value, influenced by above average pay and free accommodation. I assumed the good pay was because the location was what by some may be considered as "remote".
It soon became clear that accepting the job was a very bad decision. My visa was tied to the job, so I was somewhat stuck. I consulted with an immigration lawyer who said that I would lose my visa if I resigned, but he did advise me to keep a diary - excellent advice as it turned out later.
This is my diary:
26 July: Meeting with Dr.D at my request. Tell him that I am finding it difficult to get along with A (practice manager) and had such an upsetting incident last week when she took me to task over a phone call to a client in the presence of junior staff (vet and vet nurse) and then let it escalate into an attack with false accusations of breaking the car's gearbox and being selfish to leave a light on when I go out at night, with insinuations that I would not do it in my own home, and added that I was getting a very good salary with benefits etc until she had me in tears. As a result I consulted an immigration lawyer to determine what my position would be if I resigned. The lawyer advised that he should write a letter to D so that things are placed on record. Dr. D was very upset about this and threatened that if anything like that ever happened again, he would fire me.
I discussed more of the problems I had with A, mentioning that although I was doing my best, I constantly felt victimized by her.
I mentioned my concern about the presence of large amounts of expired drugs on the premises. He told me (falsely) that they had all been removed, though he felt it was utter bullshit and that he did not want to hear another word about it. He appeared upset and aggressive about this. I said that I did not want to act illegally in terms of the Veterinary Act. He then said that the law was bullshit too. I found some expired atropine on the work shelf in the clinic this evening (27 July). Do I risk more confrontation or ignore it?
He felt that the problems A and I were having were due to communication problems and accused me of being to blame. He then called A to the meeting. She said that her intention was not to criticize my work but to tell me how they do it here. I said that though I was happy to go along with practice policy, I still had to make a case by case decision based on what is best for the animal. D pointed out that this was not necessarily the right approach, because that would not necessarily be best for the business. He cited a recent case where I had removed a stick which had become encapsulated in an abscess under the skin over a dog's rib cage. I lanced the lesion at both ends, removed the stick with ease, flushed the abscess thoroughly and inserted a penrose drain. The dog made an uneventful recovery. However, D says that in the client's perception, he did not get value for money with two small incisions and no sutures. I should have cut open the full length of the lesion and put in many sutures - at least 10 - that way the client would feel that he got value for money and that we had done a job he could never have done himself. The job I did made him feel that he had to pay a lot of money for a simple procedure he could have performed himself. The practice charges a set fee for an abscess, regardless of size or complexity. Perhaps if I had communicated with the client rather than A, he might see the value in my approach - shorter anaesthesia, less trauma and a satisfactory outcome - but with the existing status quo that was not an option.
To be continued.....
Many years ago I moved to Australia for the first time. I responded to an add in the AVA Journal and was offered a job in a rural area. I was foolish enough to accept at face value, influenced by above average pay and free accommodation. I assumed the good pay was because the location was what by some may be considered as "remote".
It soon became clear that accepting the job was a very bad decision. My visa was tied to the job, so I was somewhat stuck. I consulted with an immigration lawyer who said that I would lose my visa if I resigned, but he did advise me to keep a diary - excellent advice as it turned out later.
This is my diary:
26 July: Meeting with Dr.D at my request. Tell him that I am finding it difficult to get along with A (practice manager) and had such an upsetting incident last week when she took me to task over a phone call to a client in the presence of junior staff (vet and vet nurse) and then let it escalate into an attack with false accusations of breaking the car's gearbox and being selfish to leave a light on when I go out at night, with insinuations that I would not do it in my own home, and added that I was getting a very good salary with benefits etc until she had me in tears. As a result I consulted an immigration lawyer to determine what my position would be if I resigned. The lawyer advised that he should write a letter to D so that things are placed on record. Dr. D was very upset about this and threatened that if anything like that ever happened again, he would fire me.
I discussed more of the problems I had with A, mentioning that although I was doing my best, I constantly felt victimized by her.
I mentioned my concern about the presence of large amounts of expired drugs on the premises. He told me (falsely) that they had all been removed, though he felt it was utter bullshit and that he did not want to hear another word about it. He appeared upset and aggressive about this. I said that I did not want to act illegally in terms of the Veterinary Act. He then said that the law was bullshit too. I found some expired atropine on the work shelf in the clinic this evening (27 July). Do I risk more confrontation or ignore it?
He felt that the problems A and I were having were due to communication problems and accused me of being to blame. He then called A to the meeting. She said that her intention was not to criticize my work but to tell me how they do it here. I said that though I was happy to go along with practice policy, I still had to make a case by case decision based on what is best for the animal. D pointed out that this was not necessarily the right approach, because that would not necessarily be best for the business. He cited a recent case where I had removed a stick which had become encapsulated in an abscess under the skin over a dog's rib cage. I lanced the lesion at both ends, removed the stick with ease, flushed the abscess thoroughly and inserted a penrose drain. The dog made an uneventful recovery. However, D says that in the client's perception, he did not get value for money with two small incisions and no sutures. I should have cut open the full length of the lesion and put in many sutures - at least 10 - that way the client would feel that he got value for money and that we had done a job he could never have done himself. The job I did made him feel that he had to pay a lot of money for a simple procedure he could have performed himself. The practice charges a set fee for an abscess, regardless of size or complexity. Perhaps if I had communicated with the client rather than A, he might see the value in my approach - shorter anaesthesia, less trauma and a satisfactory outcome - but with the existing status quo that was not an option.
To be continued.....
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