What Hernia Surgery Taught Me About Veterinary Medicine

Four weeks ago, I had surgery to repair a hernia in my abdomen. Even though it was a fairly small and uncomplicated hernia, the surgeon implanted a small piece of fortifying mesh and instructed me not to lift anything heavier than twenty-five pounds for the following six weeks. He said I could return to work for half-days in the first week post-op, so that was a nice little laugh, thinking about an ER veterinarian working a "half-day," ... What would that be? Only seven hours?

I've been an ER vet for about fourteen years, non-ER for about five years before that. All small animal. My job is very busy, very active, and very physical. But I don't think I ever knew how physical until my doctor placed a restriction on me. Still, I thought, I can probably do most of my job unaffected... right?

I should also mention I tend to be a "doer." I dive right in and help out, especially if the staff is occupied with another patient. So, in an effort to remind myself not to over-do, every day at work I would write "20#" on the back of my right hand in black Sharpie. (Much like ventilating a patient, if you don't exceed twenty pounds, then you'll never exceed twenty-five, right?)

From the very first day, I realized two important things about my job of twenty years:

1. The technicians and support staff have underappreciated challenging jobs; and
2. Veterinary medicine (even small animal) is very very physical.

I mean, I already knew both of these things on some level -- you can hardly work in a clinic without that awareness -- but from this new perspective, it really hit home.

From the very first day, when I still had pain and inflammation around my surgical site, in spite of nonstop NSAIDs and between-appointment ice packs, I felt the impact. My first appointment was simple -- a two-year old labrador for an ear infection. He was a nice dog -- but he weighed about ninety pounds. In fact, he was a bit too nice, wanting to greet me by bouncing up at me, in spite of the owner's hold on his leash -- my hands instinctively covered my surgical incision, in case a stabby paw or toenail made contact.

Typically, I just get down on the floor with the dog and perform my exam there, get the ear swab samples, do a little demo of cleaning and medication treatments, all while the patient is bouncing around underneath me. But with my post-op restrictions, I had to come up with a Plan B. I asked the client to walk their dog up onto the low-table, and then we'd use the motorized foot pedal to lift the table. She did so, but the dog kept jumping off. I explained I had an activity restriction from my own doctor, pointing to the "20#" scrawled on the back of my hand, and asked her to try again, this time keeping a hand on the dog's collar and comforting him while the table was raised. That went much better, and I was able to get the samples needed and the treatments administered.

The rest of the day went much the same way, with me guiding clients into helping me. For the most part, they were happy to comply, even though I almost always had to ask. However, there were a few clients who seemed to either be afraid of their dogs or even to feel it was not their job to provide assistance. So for these pets, I would go find a tech to go into the room to get the dog and bring it back to the treatment area.

And if I ever didn't appreciate my techs before -- and I do, I really do. -- I do now! Lacking the ability, myself, to wrestle even friendly patients (not to mention those who were fearful and/or aggressive), I had to rely on the staff to do all the restraint and lifting. Sometimes it took three or four techs to restrain a pet, between the safe handling and distraction. -- But you already know this, how "it's just a nail trim" quickly turns into a bodily fluid wrestling extravaganza involving a change of clothing for at least one staff member.

(Watch the video clip here:  
https://www.youtube.com/watch?v=8JQlsyWbxKM)

But here's what I also noticed: most of my techs are in their twenties and thirties. And they're handling patients that weigh ninety, one hundred, one hundred fifty pounds. Every day. Even if cooperative, those pets have to be lifted up and down from radiology and surgery tables, sometimes while unconscious ("dead weight"), sometimes awake and flailing. -- And you know as well as I do that most techs consider themselves part Superman and try to lift those eighty-pounders all by themselves, usually less often out of pride than unwillingness to trouble their coworkers who (especially in an ER practice) are equally busy caring for other patients.

(If our clinic ever starts see pigs as patients, we're hiring this guy.)

Here's what I also know: I'm fifty years old, and my body isn't what it used to be. Among other ailments, I have intermittent lower back pain and an occasional flare-up of a pinched nerve in my neck. I haven't had any specific accidents that have caused these conditions, just the day-to-day wear and tear of everyday life. And maybe also my career in veterinary medicine. So I can't help but wonder about my young coworkers, who have two and three decades before they reach my age. And I wonder why we don't all just take that extra two minutes to wait for a colleague to come help us carry a heavy patient, instead of trying to do it all on our own? Surely the bites and scratches and occasional head-butts are physical trauma enough, aren't they?

And then a collapsed and pale hundred-pound Lab comes through the door, and I remember how urgency trumps logic and planning, as we all dive into action around this critical patient.

But not every patient is critical, and we have to remember this is a marathon and not a sprint. We must pace ourselves and take care of our bodies, if we want to last. And so when I am cleared of my weight restriction by my doctor next week and can erase that Sharpied "20#" from the back of my right hand, I hope the spirit of its message remains.