Monday, August 19, 2019

Percy at the Hospital

I won't deny that I was more relaxed on the drive home.  Of course I worried about what was happening, but at least I wasn't the one making decisions and managing the moment to moment. I trusted the professionals at the hospital to do what they were good at and that's why he was there. 

Before I'd left home, I had posted some photos and the situation on social media. Once we were out of the city driving and on the highway that would take us back north into ever more peaceful surroundings, I checked Facebook and Instagram (my husband was still driving). The responses were overwhelming and wonderful. Not only messages of support and confidence, but offers of help. Some people offered to go visit him for me and they lived up to two hours away. Others offered to put me up if I needed to stay closer or visit. Still others contacted my with optimistic stories of their own horses' hospital visits or to give advice on communicating with staff. I hope I responded to each one but if I missed anyone, I'm sorry and appreciate it all! Positive Reinforcement people make up the nicest community and I am forever grateful. 

The surgeon had told me she'd call when the surgery was over and he was in recovery.  She said it would be about 3 hours so by 8:30 (we were still driving home), I started checking my phone obsessively. Finally the call came with word that everything had gone well and they'd flushed nine liters of fluid through his joint to be sure there was nothing left in there which didn't belong. He was in recovery and she'd call once he was up. They'd have ropes on his tail and head just in case. Eesh.  

It was dark when we got home. Another person I am grateful for is the friend/client I sent an SOS to on the way down. I had left the horses with piles of hay and most had outdoor access. But as I traveled down the highway, I found myself worrying about the four dogs confined to the house. There is a dog door but only one of them can use it for complicated reasons. I couldn't think of anyone nearby that I trusted to let the dogs out though. So I texted Cindy, who is not a horse person but is great with dogs. I tried to politely say, "only if it's not too much trouble" knowing it would be at least half hour drive each way. She agreed immediately and I could release that anxiety. She later sent pictures of the dogs outside playing, had fed the terriers, and everyone was back in where we'd left them.  So when we got home, the dogs were very happy to see us, but not as crazed as they would otherwise have been! 

I was definitely ready to collapse into bed but wasn't about to until I heard he was out of recovery. When that call came saying he had gotten up easily and seemed comfortable, the surgeon promised another call in the morning.  I didn't even have to ask. The relevant doctors on his case called every day. I only called them twice, on days that I hadn't heard from them and needed to leave cell range so didn't want to miss. When I did call, they always connected me to his doctor in short order. I got thoughtful reports, they listened to my suggestions, and they answered my questions.  

So the big question is, how did this sensitive, clicker trained, country boy do in the hospital? Honestly I don't have a lot to go on since I wasn't there, but I'll share what I do know. 

From the doctors I spoke with: they knew I was concerned about his behavior. I wanted him as happy as possible of course, but I also made clear that I was worried for their safety. He's not subtle when he's upset. I would say that their reports on his behavior indicated improvement over the week. The first few days I heard, "we had to sedate him pretty well to treat him". For treatment, he had a catheter in his neck so that they didn't have to poke him for his antibiotics and sedatives. He had another catheter in his knee for regional limb perfusions- they put a tourniquet on his leg and then flooded the knee itself with antibiotics. They did that every other day. They also had to check the wound and change the bandages. 

After the first few days, the reports were more along the line of "he was pretty good today".  "I didn't have to sedate him for the bandage change". That, to me, was progress. I hoped that the sedation was keeping Percy relaxed and people safe, and that they were all learning about each other.  The morning after the surgery, the surgeon told me she was transferring his case to two other doctors who would be responsible for his after surgery care. Sure enough, the next day I got a call from one of them. I always tried to express my gratitude and trust when I spoke to them. Percy was in their hands and they needed to be reinforced for that! I told that new doctor about the success with the blindfold and she said that was very helpful. She said the others had told her to keep people to a minimum. That told me that my suggestions were being taken and passed along.  When I asked a few days later if the blindfold was still working, she said, "we don't need it any more.  He's fine without it".  More progress. Yes, he was still getting sedated for treatments but I've seen what he can do even when sedated so I knew that wasn't the only factor. 

After five days, that doctor, who was a resident, was transferred to another specialty and I had yet a third new person to talk to. His comment about him was, "he's quite a character".  Bingo.  

My biggest boost was a visit from yet another friend/client. When I initially heard all the offers to go visit him, I thought I could make a visitation list and he could have a visitor every day. But I wondered if that would be a good thing or a bad thing. Would he appreciate yet another new face every day? These were all clicker trainers offering, and my thought was to have them run through foundation lessons with him but would that be confusing with all those people? Would he get frustrated when some people spoke his language and others (hospital staff) didn't? The general rule is, if the animal doesn't have a choice, it's far better not to offer one, than to have to ignore the answer. Did I need to extrapolate that theory to "this place is about a different mindset"? Again, I had nothing to go on. 

I decided to try one visitor and see how it went. I chose the person the shortest distance away and hoped would be the least inconvenienced. I asked Ally if there was a feed store or something nearby where she might find a toy to take to him.  When she listed several and then said that Smart Pak was close, I was ecstatic.  I called Smart Pak and asked if I could pay for things over the phone for her to pick up.  She said they did that all the time for Tufts clients.  Finally, something I could DO for him. I got online and picked out a food interactive toy that could be stuffed with carrots, a peppermint flavored (supposedly) jolly ball, a bag of treats and a Himalayan salt block on a rope. 

When Ally sent the photos from her visit, it was the highlight of my week. She told me his stall was immaculate and so was he. That was a relief because I knew how sweaty he'd been and was worried he was still caked with salt. She said there was a bucket of brushes hanging on his door. Such nice news. 

Another reason I picked Ally to be the one to go visit is because she had been here for some lessons and had attended our Training Intensive this summer. So I'd seen her work with my ponies and knew that she knew my priorities. When I told her I wasn't sure how interested he'd be with the sedation, she said, "I'll just offer to interact with him and see what he says".  Oh, that was just what I needed to hear. Plus, she's a KPA grad, so I knew she was special. 

She was texting me while she was there and sending photos and videos. She said the salt inspired the most interest so I was glad I'd sent it. She also said he loved the fan they put up for him.  He could stand in front of the fan and lick his salt. He wasn't interested in treats though, so there was no "training". I have to say I was a little concerned with the lack of interest in treats and how depressed he looked. I knew they were sedating him for morning treatments but she visited in the evening so the Ace should have worn off by then. I made a note to ask the doctor on the next call. 

As happy as I was to see the photos and videos of Percy, one of my favorite pictures was: 

Percy is a Houdini and knows how to get someone's attention. He can also get a little panicky when he thinks it's time to go out.  I wasn't sure which of these were the stimulus for his escaping behavior but the fact that he had enough spunk to try to escape was an indication to me that he didn't feel too badly. 

When I spoke to the doctor the next day, I mentioned that the horse I saw in video and pictures was either sedated or depressed. She didn't think he should have still been sedated but assured me they were taking vitals each day and none of that indicated a problem.  [note: now that Percy is home, he does not want those treats either.  Maybe it was just a preference that made him turn them down with Ally. I thought he'd like them as special. Lesson learned!] I also asked her about the escaping sign and said she had not had any trouble with him herself and guessed it was stall muckers who may leave the door open a little. I told her how easy it was to stop him with a "whoa" but they better be ready to "pay" for it or he wouldn't stop the next time. I'm not sure if that information was passed on or not but they probably thought it safest not to risk it. 

enjoying his salt
The day after her visit, the report was that he was going well, the wound looked good, he was looking sound at a walk (on bute) and if all continued that way, he could come home on Tuesday.  More good news!  That would be just six days there. As a result, I decided not to chance any more visits. Somehow with the short duration left, it seemed better to leave him in his semi-sleepy state than get him thinking he could solicit attention for playtime. 

As it turned out, that resulted in my only disappointing communication. I continued to speak with the doctor daily, but on Sunday, she left for her next rotation and I had a new person to speak with. I did not hear from him on Monday and had cancelled all my Tuesday appointments to clear our schedule to go get him.  Not having heard anything, I called about 4:30 and found out that no, it would be better to get him on Wednesday. Grr. When they heard my frustration, the doctor said I could get him Tuesday if I really needed/wanted. But since the reason they were holding off was because they had not transitioned him to the oral antibiotics and sedatives yet, I agreed that I wanted him to transition there and make sure all was good before bringing him home. 

Having already heard that he'd need to be on stall rest for a period of time, I thought a lot about how I would manage that. We put screw eyes up over his dutch door so I could hang a stall guard in case he wanted to jump out, or even lean too hard on his door in his desire to be out. He has already bent the sliding latch from doing so before. I also cleaned all the old shavings out of his stall, swept down the walls and ceiling, and left it to air out. I ordered sheet cotton and vet wrap in bulk. The hardest part was figuring out how to adapt a very active, sociable, and playful horse to stall rest. I had some ideas to try, but I wouldn't know how they worked without trying them. 

Wednesday morning, I packed a bag of carrots with our lunch and snacks for the drive down. 


DIana said...

Loving your account of events. You write so well!

Bookends Farm said...

Thank you Diana!