Despite my house falling apart around me, luck smiled upon me Monday. Dr. Snyder called, around noon I think, to discuss Snoopy. He sounded like he was on his car phone; either that, or he was standing in the middle of a freeway.
I went over the same things that I told Dr. Nieto - or whoever it was - about Snoop's broken foot, short-striding, handwalking since August, yadda, yadda. I added in what Dr. Pollard had written down for me to tell him about the diagnostic anesthesia: "Abaxial nerve block was essentially negative. Low 4-point block was 80%+ better."
Dr. Snyder was as patient and nice as Dr. Nieto-whoever and said that it sounded like insertion desmitis was the correct diagnosis. He offered three options:
1. Stem cells - I thought this therapy was only useful for new injuries, but Dr. Snyder told me they've been having a lot of success with chronic problems. The downside to this therapy is that it's wildly expensive, about $3000. I'd have to sell a lot of copies of Freezer Burn to justify it.
2. Shock wave - Dr. Snyder assured me that this was much less expensive, and wouldn't harm Snoopy at all. The worst that could happen is that after spending money on the treatment, it wouldn't work.
3. Continue with the current therapy - which is just walking.
Dr. Snyder recommended the shock wave plus the walking regimen. He said the next ultrasound (due April 26) would show whether there was any improvement. Actually, he sounded like he would be interested in knowing how the ultrasound turned out.
So that's what we're going to do. Tina spoke with Brigid (Dr. Murphy) who said Dr. Martinelli had the best shock wave machine around. He is down in San Marcos, but he's the head of California Equine Orthopedics, and he treated Copper, Tina's old show horse, so he sounds pretty good. I'll set up the appointment, then figure out how to get Snoopy down to his facility.
I'm actually kind of excited to have him treat Snoopy. I don't want this blog to sound like I just want my horse to be instantly healed. If it takes a year for him to recover, it takes a year. What I want to avoid is for Snoopy to end up an invalid because we didn't push enough, stretch him enough, etc.
Trust me - I'll keep you all informed.
Showing posts with label dr. snyder. Show all posts
Showing posts with label dr. snyder. Show all posts
Wednesday, April 1, 2009
Monday, March 30, 2009
For my next trick...
I don't have anything truly revelatory to report here, but I have been using this blog as a way to communicate with the vets as to when things happened with Snoopy. After my dismal e-mail exchange with Dr. Nieto, I decided to wipe the slate and start from scratch. I would call UC Davis anew, as if I'd never called before. Dr. Murphy and I spoke on Saturday about my troubles, and she said, if necessary, she'd get involved in the mix.
This morning, I called UC Davis and asked to speak with Dr. Snyder. The woman answering the phone said she'd put me through to his voicemail if he didn't answer. Of course he didn't answer - what doctor every answers? It was a little disconcerting - there was no outgoing message on his voicemail, no "Hello, you've reached me." Instead, I heard a beep, then Little Miss Computer Voice told me to press 2 to continue to record my message. I pressed 2, heard another beep, and recorded what I'm certain is a long, rambling, message, accompanied by every phone number I will be even close to - I considered leaving the number to Albertson's since I plan to do some shopping later, but I didn't.
The problem with leaving a message is that I really need to have Snoopy's big folder in front of me to discuss his injury and treatment in terms a doctor can understand. So I'm hoping Dr. Snyder returns my call today, while I sit home, patiently waiting for the Home Depot to deliver and install my new water heater. The past week has been trying for the Carline household. The microwave is broken, the water heater leaked all over the garage (and the shut-off valve broke, meaning we spent most of Friday night and Saturday was spent without water entirely), the dishwasher won't drain and there's a leak under the kitchen sink. When the bees showed up in our chimney on Sunday, it really was the last straw.
And, to top it off, my horse is still lame.
This morning, I called UC Davis and asked to speak with Dr. Snyder. The woman answering the phone said she'd put me through to his voicemail if he didn't answer. Of course he didn't answer - what doctor every answers? It was a little disconcerting - there was no outgoing message on his voicemail, no "Hello, you've reached me." Instead, I heard a beep, then Little Miss Computer Voice told me to press 2 to continue to record my message. I pressed 2, heard another beep, and recorded what I'm certain is a long, rambling, message, accompanied by every phone number I will be even close to - I considered leaving the number to Albertson's since I plan to do some shopping later, but I didn't.
The problem with leaving a message is that I really need to have Snoopy's big folder in front of me to discuss his injury and treatment in terms a doctor can understand. So I'm hoping Dr. Snyder returns my call today, while I sit home, patiently waiting for the Home Depot to deliver and install my new water heater. The past week has been trying for the Carline household. The microwave is broken, the water heater leaked all over the garage (and the shut-off valve broke, meaning we spent most of Friday night and Saturday was spent without water entirely), the dishwasher won't drain and there's a leak under the kitchen sink. When the bees showed up in our chimney on Sunday, it really was the last straw.
And, to top it off, my horse is still lame.
Saturday, March 21, 2009
A brake in the action
Yes, I mean "brake", as in "putting on the brakes."
To recap, we're trying to find the source of Snoopy's discomfort with his left hind foot. The fracture has healed. Dr. Fischer thinks it's tendinitis, at least the equine version. The exact wording was, "the superficial digital flexor tendon was enlarged at its insertion and had hypoechoic areas in each branch."
Got that?
His recommendation was to handwalk Snoopy for 30 minutes a day and bring him back in 60 days for more tests. This might be fine if we hadn't already been walking Snoopy for the past, oh, eight months or so with no improvement. My insecurity about Dr. Fischer's diagnosis comes from watching him do the ultrasound - he never seemed to have that "AHA" moment, when he points to something on the screen and says, "Look at that." He only waved his finger about and used words like "seems to be", "looks like", "maybe". I don't care how sure he was about his diagnosis when he spoke to me in the office, I didn't see that same degree of certainty in the examination.
Oh, and NOTE: **To All Horse Owners Who Have Ultrasounds Performed** When they are doing the ultrasound, request that they print at least TWO copies of the ultrasound pictures. As state-of-the-art as my equine hospital may be, they cannot save the ultrasound electronically, like they can their digital x-rays. So everytime I want a second opinion from another vet, they have to send the original to the vet, along with a SASE to send it back when the vet is finished with it. This is important to know.
I called UC Davis and spoke with Dr. Nieto, who talked to me about Snoopy's problem for about 20-30 minutes, then said he'd rather not look at medical records, he'd rather see the horse at this point. He told me that the first thing he'd do is perform his own ultrasound, then do pain blocking to pinpoint the source of Snoopy's pain. This is also called "diagnostic anesthesia" - you numb the hoof, see if the horse still limps, then numb the fetlock, and work your way up the horse's leg to find out where the problem is.
Dr. Fischer had refused to do this blocking. According to him, you risk injuring the horse by allowing him to put full weight (or full range of mobility) on a hurting limb. The other vets I spoke with disagreed with this. Their arguments were that: 1) you only trot the horse briefly to see if it still hurts, and 2) after you perform the procedure, you put the horse back in his stall until the anesthesia wears off.
I scheduled Dr. Pollard to do the pain blocking. He had to cancel the first appointment, but he was on time the second time and I watched him work. We started with the hoof. There was no change in Snoopy's trot; full stride on the right and a half-stride on the right. It was a little funny to watch Snoop walk the first few steps with a numbed foot - he couldn't find his foot or the ground, so he kept lifting his foot uber-high, then kind of slop it down. After awhile he figured it all out and was as good a patient as he could be, under the circumstances, the circumstances being that Dr. Pollard didn't want him sedated while we trotted him.
Dr. Pollard next went to Snoopy's fetlock. Snoopy was, by this time, very happy to be out of his stall and be allowed to trot, even if it was supposed to be slow and even, with a stud chain. Poor Niki has bad knees and a broken toe, but Tina was sick with some kind of crud and couldn't jog very far, and I'm the mom, so no one trusted me with him. (This is okay, I understand. I taught him all his bad behavior.)
The fetlock numbing made him trot a lot better. Not 100% better, but a lot better. Dr. Pollard officially described it as 80%. He wrote me a note to describe his findings and told me to call UC Davis again and offer to send them the x-rays, the ultrasound and his findings, to see what they have to say.
By the time I got home, it was too late to call, so I emailed Dr. Nieto, reminding him who I was and what we discussed, etc. The next day, I got this email from him:
"Dear Gayle, I think you have the wrong person. I have not talked to you about your horse. Sorry, Jorge Nieto"
WTF? His was the name I heard when the woman at the office said she'd transfer my call. His name was what I heard when the voicemail picked up. No one else on the website has a name even NEAR 'Nieto'. Did I spend 30 minutes talking to an imposter?
Honestly, I felt like someone had punched me in the stomach.
I emailed back: "I'm sorry to press one more time, but I called UC Davis Large Animal Hospital, Equine Clinical Services on Friday, March 6th and explained my horse's problem. They transferred me to the voicemail of Dr. Nieto, and I left a message. About 20 minutes later, a doctor called and we discussed my horse - I perhaps assumed it was Dr. Nieto? Or is there another doctor on staff whose name sounds very much like yours?"
I'm hoping that sounded like perhaps I made a mistake but perhaps you just forgot about that Friday phone call - because, because, um, it was Friday afternoon and you'd already had a few gin & tonics?
Today I decided to start all over again and leave a message for Dr. Snyder. I called UC Davis, only to be told that Dr. Snyder doesn't have his voicemail set up! Sigh. The lovely young girl told me to call on Monday, during regular office hours and they'll help me.
In the meantime... we walk.
To recap, we're trying to find the source of Snoopy's discomfort with his left hind foot. The fracture has healed. Dr. Fischer thinks it's tendinitis, at least the equine version. The exact wording was, "the superficial digital flexor tendon was enlarged at its insertion and had hypoechoic areas in each branch."
Got that?
His recommendation was to handwalk Snoopy for 30 minutes a day and bring him back in 60 days for more tests. This might be fine if we hadn't already been walking Snoopy for the past, oh, eight months or so with no improvement. My insecurity about Dr. Fischer's diagnosis comes from watching him do the ultrasound - he never seemed to have that "AHA" moment, when he points to something on the screen and says, "Look at that." He only waved his finger about and used words like "seems to be", "looks like", "maybe". I don't care how sure he was about his diagnosis when he spoke to me in the office, I didn't see that same degree of certainty in the examination.
Oh, and NOTE: **To All Horse Owners Who Have Ultrasounds Performed** When they are doing the ultrasound, request that they print at least TWO copies of the ultrasound pictures. As state-of-the-art as my equine hospital may be, they cannot save the ultrasound electronically, like they can their digital x-rays. So everytime I want a second opinion from another vet, they have to send the original to the vet, along with a SASE to send it back when the vet is finished with it. This is important to know.
I called UC Davis and spoke with Dr. Nieto, who talked to me about Snoopy's problem for about 20-30 minutes, then said he'd rather not look at medical records, he'd rather see the horse at this point. He told me that the first thing he'd do is perform his own ultrasound, then do pain blocking to pinpoint the source of Snoopy's pain. This is also called "diagnostic anesthesia" - you numb the hoof, see if the horse still limps, then numb the fetlock, and work your way up the horse's leg to find out where the problem is.
Dr. Fischer had refused to do this blocking. According to him, you risk injuring the horse by allowing him to put full weight (or full range of mobility) on a hurting limb. The other vets I spoke with disagreed with this. Their arguments were that: 1) you only trot the horse briefly to see if it still hurts, and 2) after you perform the procedure, you put the horse back in his stall until the anesthesia wears off.
I scheduled Dr. Pollard to do the pain blocking. He had to cancel the first appointment, but he was on time the second time and I watched him work. We started with the hoof. There was no change in Snoopy's trot; full stride on the right and a half-stride on the right. It was a little funny to watch Snoop walk the first few steps with a numbed foot - he couldn't find his foot or the ground, so he kept lifting his foot uber-high, then kind of slop it down. After awhile he figured it all out and was as good a patient as he could be, under the circumstances, the circumstances being that Dr. Pollard didn't want him sedated while we trotted him.
Dr. Pollard next went to Snoopy's fetlock. Snoopy was, by this time, very happy to be out of his stall and be allowed to trot, even if it was supposed to be slow and even, with a stud chain. Poor Niki has bad knees and a broken toe, but Tina was sick with some kind of crud and couldn't jog very far, and I'm the mom, so no one trusted me with him. (This is okay, I understand. I taught him all his bad behavior.)
The fetlock numbing made him trot a lot better. Not 100% better, but a lot better. Dr. Pollard officially described it as 80%. He wrote me a note to describe his findings and told me to call UC Davis again and offer to send them the x-rays, the ultrasound and his findings, to see what they have to say.
By the time I got home, it was too late to call, so I emailed Dr. Nieto, reminding him who I was and what we discussed, etc. The next day, I got this email from him:
"Dear Gayle, I think you have the wrong person. I have not talked to you about your horse. Sorry, Jorge Nieto"
WTF? His was the name I heard when the woman at the office said she'd transfer my call. His name was what I heard when the voicemail picked up. No one else on the website has a name even NEAR 'Nieto'. Did I spend 30 minutes talking to an imposter?
Honestly, I felt like someone had punched me in the stomach.
I emailed back: "I'm sorry to press one more time, but I called UC Davis Large Animal Hospital, Equine Clinical Services on Friday, March 6th and explained my horse's problem. They transferred me to the voicemail of Dr. Nieto, and I left a message. About 20 minutes later, a doctor called and we discussed my horse - I perhaps assumed it was Dr. Nieto? Or is there another doctor on staff whose name sounds very much like yours?"
I'm hoping that sounded like perhaps I made a mistake but perhaps you just forgot about that Friday phone call - because, because, um, it was Friday afternoon and you'd already had a few gin & tonics?
Today I decided to start all over again and leave a message for Dr. Snyder. I called UC Davis, only to be told that Dr. Snyder doesn't have his voicemail set up! Sigh. The lovely young girl told me to call on Monday, during regular office hours and they'll help me.
In the meantime... we walk.
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