This is me and Tiller, while I studied for Step 1:
(This tangentially connects to medicine I promise)
Tiller is a mutt: half-beagle, half-something else. We think it might be golden retriever, but no one is sure because he is tremendously misshapen. He has a tiny beagle-shaped head, a huge chest, stumpy legs, and enormous paws. He is the Mr. Potato Head of dogs.
Tiller is great. He loves people, will play fetch for hours, is good-natured with humans, gets along with other dogs, and will do essentially anything for peanut butter or cheese. He sits, he stays, he walks on the leash, and he howls every day at noon when the church bells nearby ring.
Incidentally, Tiller is also a genocidal maniac who cleaned out our yard of all life larger than a beetle. This is Tiller murdering one of the last rabbits in our yard (trigger warning, haha):
An interesting fact about Tiller is that he eats absolutely everything except, as far as we can tell, lettuce. Here is a partial list of the foods that regularly appear on Tiller’s menu:
- Table food, all kinds
- Peanut butter
- Dead Animals
- Balls of String
About a week ago, Tiller (who lives with my parents back in DC) got sick. He started throwing up and looked bad, so my mom took him to the vet. They took an X-ray, which showed the following:
So what is that huge circular thing in his stomach? I have had great fun showing my various residents on anesthesia this image. So far – and bear in mind these are doctors – answers have included a quarter, a ring, a golf ball, and a mini-frisbee. No one approached the size of the actual ingested object, which was this:
The quarter is for scale. My IDIOT dog somehow decided it was both possible and a good idea to swallow an entire, inflated tennis ball. What the hell!? How did that go down? How could he possibly have eaten this without anyone noticing? How does one “eat” a rubber ball at all!?
The vet said they would attempt to remove the “foreign body” from his stomach with an endoscope. If the endoscopy failed (which it did, because he swallowed an enormous tennis ball, because he is an idiot) they would have to cut him open and take it out manually. So my dog got emergency dog surgery, which I honestly did not know was even a thing until this all happened.
After the surgery, which lasted for a few hours, they monitored the moron overnight and sent him home with my parents the next day with thirty staples and a prescription for Tramadol, a synthetic opioid that I have learned all about on my anesthesia rotation.
(I told you it connected to medicine! He’s also on massive, three-times-a-day doses of gabapentin, which I find hilarious for reasons that are not politically correct to explain on the Internet.)
Tramadol, which is marketed as Ultram, is in medical terms a “centrally-acting opioid agonist,” which means it binds to receptors in the brain and spinal cord, which then send signals telling your body that you are in less pain than you actually are. But the receptors that bind Tramadol, and others like it, also do many other things in the body, like zonk you out, give you a high, and make you constipated.
In lay speak, this means that opioids Do Stuff and we aren’t really sure how or why. But dammit, they Do Stuff.
This is Tiller immediately after his surgery, in considerable discomfort:
This is Tiller after the Tramadol has kicked in:
As you can see, Tiller is higher than a weather balloon in this photo. In case you can’t tell, his gaze is directed squarely at the wall. He was probably having crazy dog dreams about killing more rabbits.
I have thus renamed the dog “Tramadog.”
Tramadol also can cause paranoia, hallucinations, and insomnia. I have no idea how you assess paranoia in my dog, because Tramadog is at DEFCON 1 at baseline. When I was with him during Step 1 study time, he once spent the hours from 5am to 7am staring into a drainpipe because he thought he saw a rabbit in there. He’s hypervigilant by default.
As a Concerned Medical Student Who Has Medical Knowledge, I have been asking all of the appropriate questions in daily phone calls with the Bringers of Life – is he pooping? How much pain is he in? Is his wound site getting hot and red? Can you see red stuff between the staples?
Mostly I am concerned with pooping, because with the doses of opioid Tramadog requires are enough to make him not poop again until 2017. This would, at a minimum, be bad for his incision site, and in the short term could inspire an eventual reflex/makeup poop that would clear the dog park of all life and require the authorities to declare the entire city block a hazmat zone.
Mostly I just want to go home and be with the Tramadog.