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Keratoma Surgery Updates: Returning Home & Rehab

Well, it’s been a busy and stressful couple of weeks. I think I am only just starting to understand how much the beginning of my year threw me off kilter. I can’t seem to get a handle on anything, no matter how hard or fast I work.

The good news is that everything with Tristan is proceeding exactly as we hoped. When last I blogged, I wrote a short note to say that his surgery went well. It went really precisely as we could have hoped. The next morning the vet texted me to say that he had jogged out almost entirely sound, and got his glue-on shoes put on by the hospital vet. I got to see him briefly that afternoon, which was a huge relief.

I hadn’t made any plans at all until after I head his surgery went okay, so I jumped into action and updated the shipper, the barn, and worked on my own travel plans. The shipper put us on the schedule tentatively for Sunday, and I only had my AirBnB through Friday, so I made a hotel reservation for Friday & Saturday. I cleaned up, did some laundry, and actually got out and about a little bit. It worked out really well that we were shipping Sunday; Friday & Saturday was the polar vortex in Vermont, with -20F actual temps, and I had been starting to worry about bringing Tristan from his heated barn in (relatively) tropical Pennsylvania into that.

New Bolton has extremely restrictive social media policies aka NO PICTURES AT ALL EVER, so here, this is lovely downtown Kennett Square, where the clinic is located.

One of the places I went on Friday was Bartville Harness, which was a very cool place to visit and made me wish that a) I wasn’t about to be flat broke and b) that I wanted or needed anything leather-related. Tons and tons of gorgeous stuff at really extremely reasonable prices! I also ended up there because Google told me that Nunn Finer still had a retail store. When I drove by there was an RV store there…so I called…and talked to John Nunn himself, which was fun! And in the moment he said it, I remembered that he wasn’t doing retail anymore, just wholesale to other stores & through the website. So, Bartville it was.

On Saturday, I went out and about a fair bit more. The AirBnB was comfortable and cozy so I processed stress by hiding under blankets there. The hotel room was tiny and impersonal (though clean and otherwise fine!) so it was easier for me to go out and about. I visited a local Dover and bought a few things for Tristan’s rehab, and then over to a Maryland Saddlery consignment store branch. I almost bought a sweater but wasn’t sure about the sizing, and after 20 minutes of waiting for the lone changing room, I put it back and left empty-handed. I also went to Fair Hill Saddlery and bought some dry shampoo.

I also almost bought Tris a wool Baker sheet for $50 but he absolutely did not need it, so I left it there. This is Maryland Saddlery’s Hockessin location.

On Sunday, we got a slightly later start than intended, and I had several conversations with New Bolton about getting him ready. “Yes, I want all the blankets on him, in the order I told you. I know it’s 50 degrees here. It’s going to be way colder at home.” I also had sent him down with a zippered canvas bag full of his grain, papers, treats, extra halter, etc., and I hadn’t been able to learn from anyone whether I’d be getting it back. It wouldn’t be a huge deal if it had gotten lost, but I did at least want to know. Thankfully, at one point a lovely vet tech came out with his discharge instructions – which I hadn’t laid eyes on until that moment – so I had about 30 minutes to review them and then email them to my barn manager and vet. I had been worrying a bit that if there was anything complicated or different than expected I’d have to scramble to arrange it while driving home. Nothing like that – pretty straightforward!

Overall, that morning was a fairly typical interaction. The people were so, so lovely when I actually talked or worked with them. They did a spectacular job handling and managing Tristan, and of course treating him for the actual medical problem that was the reason he was there. The administration and overall communication absolutely blew chunks – from secret verbal-only policies about visitation that conflicted with their written policies as published on their website to the whole black-box nature of everything. It was very much a “we’ll tell you what you need to know when we feel you need to know it” attitude. I’m sure that would be terrific for some people. It gave me more or less constant heartburn. I’ve spent 18 years advocating for and managing this horse, and simply putting him in the hands of people I’d never met, no matter what their reputation, and then having close to zero information or insight into what was happening with him was HUGELY stressful.

Snapped this as the shipper was pulling away from Vermont. Tris watched me the whole way down the road. Yeah, I cried a lot.

Anyway. I digress. When the shipper arrived on Sunday, they brought Tris out to me and after a relative minimum of fuss he got on the trailer. He was clearly furious that he had to get back on – he stopped cold and looked back over his shoulder at the barn like “but…all I have to do here is look cute and eat hay and it’s heated and my stall was huge and you want me to get back on that thing?!” So he balked a touch more than he had in getting on for the trip down, but I put the chain on, we had a word or two, tons of praise for any forward motion, and after a couple of back and forths he sighed heavily and got on. And proceeded to paw the everloving shit out of the floor. With his left front, at least, so he clearly felt comfortable and weight-bearing on the surgery foot! The little shit.

My drive was totally uneventful if long, and I got to Vermont about 45 minutes before Tris. He came right off the trailer happily in the dark, attacked the hay waiting for him in his stall, and rolled and rolled and rolled in the fresh shavings. I gave him some more electrolytes that night just to be neurotic. The next morning he’d had plenty to drink and eat and had passed plenty of manure, and we all breathed a sigh of relief.

This is getting long, so I’ll cover his rehab path going forward.

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Very quick Tristan surgery update

I will have more substantial updates later, maybe, but for now:

  • Tristan shipped down on Sunday, January 29, a touch earlier than planned but better early than late! He ended up spending 13 hours on the trailer but handled it beautifully.
  • He had his surgery this morning, February 1, and it went precisely as planned. The surgeon removed the keratoma, and because we caught it so fast, he did not have to debride the coffin bone at all.
  • Tris handled the anesthesia beautifully – you may remember that I thought they would be able to do the surgery standing under local, but that was not the case. Regardless, he had zero problems and when he woke up he looked around and calmly stood up.
  • Apparently all the vet students are quite charmed by him!
  • I haven’t been able to see him much due to weird mixups about secret unpublished COVID rules, but hope to get a little time with him tomorrow.
  • Since Vermont is about to experience a hideously dangerous cold snap on Friday and Saturday, I’m hoping to target Sunday for his return. It doesn’t feel smart or safe to move him from a heated barn to a place experiencing -20F actual and -50F windchill temps.

I got basically nothing done today, could practically feel my brain slipping gears whenever I tried to concentrate, but this evening I am finally releasing some of the stress and able to focus again.

Hopefully my next update is that Tris is home safe and sound and we are on the rehab path!

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Keratoma Surgery – Financial Transparency Edition

Last time Tristan had surgery on this foot, for an ever-so-slightly different problem, I did a wrap-up post about the costs, because I think it’s useful for people to know and think about these things.

First things first: I do not have insurance. I guess I have sort of self-insured because I have worked very hard for many years to build up savings accounts specifically for Tristan emergencies. They will take a significant hit with this surgery, but they are enough for me to be able to say that money will not be the thing making any decisions for us over the next couple of weeks. I get to focus solely on ensuring the best possible outcomes. I’m grateful for that.

I’ll post further with updates as things evolve, but here are where things stand today, 10 days out from the surgery.

DateCategoryDescriptionAmount
1/10/23VeterinaryDiagnosis by home vet, rads$450.00
1/11/23Misc. CareBOT bell boots$49.65
1/20/23Misc. CareWrapping supplies$46.35
1/20/23TravelAirBnB Reservation$556.76
1/31/23TravelShipping estimate (VT->PA)$1,250.00
2/1/23VeterinarySurgery estimate$2,800 – $3,900
2/3/23TravelShipping estimate (PA->VT)$1,250.00
Total so far:$6,402.76 – $7,502.76

Likely additions going foward:

  • local vet aftercare & checkups
  • specialty shoeing (glue-ons for at least one cycle)
  • extra hospital costs if he has to stay a few days or receive more hands-on treatment
  • extra travel costs for me if I have to stay down longer than my current reservation, plus gas & food
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Random brainstorming ahead of the trip

I’ve never traveled this far with a horse before, OR used a commercial shipper, so any advice is greatly appreciated!

Prep ahead of the trip

– Tris is gradually getting used to wearing his Back on Track products for longer and longer periods of time; that’s his bell boots, front leg quick wraps, and sheet. My plan is to ship him in the sheet and bell boots, and mayyyyybe the quick wraps? The bell boots will also come in handy post-surgery, as they are meant to increase blood flow to the hoof.

– I’ve got the go-ahead to hand walk, and so every day we are going to do a deep groom, 20-30 minutes of hand walking, some stretching, and start practicing some of our in-hand trailer loading skills. It’s been 4 years or so since he last loaded on a trailer, and he’s never been great at it. The idea is to keep up his muscle tone and overall movement even though he’s not in work, and to work especially on his “step up” in hand, his cue to take one step forward at a time, which was key to his previous trailer loading. (I had it so ingrained that even when he was overall refusing life, I could usually get him to take a step forward; string enough of those together and he’s on before he knows it.)

– This weekend I’ll pull out our old travel trunk and empty and repack it with things we might need on the trip. That will probably travel down with me in my car, since it’s more “nice to have” stuff than stuff he will need on the trailer itself. In there will go things like a backup halter and lead, any other blankets I might want to bring, grooming tools in case they let me in with him, that kind of stuff. (I am guessing New Bolton will have far stricter rules than our local equine hospital, who let me take my book into his stall with him.)

– I’ve started shifting money around in and out of various savings, ugh, and stopped spending on anything not absolutely 1000% necessary.

Awkward hand walking selfie

Still to figure out

– Exact shipping dates, and I know this is the way the world works and I know everyone else deals with it all the time but WOW, I can’t even express the heartburn of doing a major trip in two weeks and the plan for shipping being “sure, we can do something around that date, let’s touch base five days out.” I HATE IT.

– Exactly what the hospital needs/wants for him to have while he’s there. Am I going to be that person that brings his hay from home? TBD. How to pack up grain, supplements, etc? Does he need his own buckets? Do I need to label all of his stuff in a specific way?

– I think I have an AirBNB picked out but I need to decided how many days to get it for (see above re shipping) and whether I really need something nicer but a touch further away from the hospital? Pursuant to the questions about the hospital, they’re probably not going to want me sitting around all day (again, bless our regional folks who let me camp out in their waiting room with my work stuff for two days).

– Waiting on a conversation with the surgeon for some last questions, and the one I haven’t asked yet because I can’t quite emotionally wrap my brain around it is prognosis for soundness. All signs point to yes, but ugh, I just can’t quite get there yet.

The first time I took him out of his stall in almost two weeks and he STILL resorted to his usual delaying tactic.

Planning for aftercare

– I’ve started organizing up all my medical supplies, and bought new stocks of my favorite duct tape (yes, I have a favorite, I have zero shame about this) and Elastikon. God, do I wish something else worked as well as Elastikon because that stuff is so expensive.

– I’ve also put a weather eye on all my commitments for February; I have my leadership training for the first few days after we return but! It’s the only session that will be near where I live already, and just two towns over from Tristan, hallelujah, so I can sneak out early morning or late at night to check and rewrap if I need to.

– In theory, this should be an easier aftercare than last time, so I am cautiously optimistic that the hurdle of the surgery itself will be the worst part.

Anything I’m missing???

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Well, that escalated quickly

So when we left it, I was waiting for the results of Tristan’s specialty radiology consult.

Consult is in and the diagnosis is clear: Tristan has a keratoma growing at the site of the old surgery on his coffin bone.

I guess the good news is that it’s a clear and unequivocal diagnosis with a straightforward path.

The bad news, however, is that it will require surgical removal. The news that actually made me burst into a short bout of mildly hysterical laughter was that he has to go to New Bolton for the surgery.

See, there’s a surgeon there that my vet has worked with who is spectacular at this work, and has pioneered a new way of doing this surgery that goes in through the hoof wall in conjunction with a CT scan of the hoof. It can be done under sedation with a local block, standing, and heals faster, more cleanly, and is more precise. All of that is exactly what you want with a 27 year old horse.

All good things. That require me to get him to a vet hospital 7.5 hours away. I know, some of you out there are thinking “I travel that far just to school XC!” Consider that in New England, an hour in any direction puts us in a new state and/or country.

The rule, though, is that he gets whatever he needs (and the vast majority of what he wants). So the surgery is scheduled for February 1, as of right now. I have to spend the next few days calling every shipper I can find to see if any of them will take my horse to Pennsylvania in the middle of winter. (If you have any ideas at all, please reach out!)

It’s never dull around here. At least I can still wrap a foot like nobody’s business.

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Starting the new year off with a bang

Hahahahaha. Oh, horses.

I was away last week, taking some time for myself to reflect ahead of the new year. While I was gone, I put Tristan in training. On Wednesday, they took him out to longe, and he was a smidge NQR. That’s not terribly unusual for him, but he was cheerful and moving out, so they did a light work. Thursday, he came out and was three-legged lame on the RF. His fetlock was far more puffy than usual, and over the course of the next day and half he blew up his leg below the knee. Limited turnout on Friday was not a success.

I got back in town Sunday, and found a very cheerful horse who was a little sick of being stuck inside and whose leg, after 12 hours of standing wraps, was still blown up and warm. He was clearly lame even in his stall; he would rest a hind leg but when he shifted from one area of his stall to the other he didn’t want to weight that right front at all. Levels of “fuck” were now upgraded.

Tuesday, the vet was out for other horses and got to spend some quality time with him. (Of course, I was in a non-negotiable staff retreat all day, so could not be there, which put me in a horrifically bad mood, not what you want when you’re doing strategic planning.)

As the barn manager took off his wraps, she noticed a hot, puffy area right at the coronet band. Great! Abscess!

Except – abscess in his right front. You know, the foot of endless complicated medical lore, where he’s missing about 30% of his coffin bone from previous infection and stress fracture.

I gave the all-clear to every possible diagnostic they wanted, and to send the many views of his foot off to specialty radiologists to read. I filled up a whole Google Drive folder with his previous x-ray photos (if you really want to look at a million images of a foot, you’re welcome to peruse).

Right now, we wait. Our best-case scenario is that he’s just got an abscess, because the scar tissue in that hoof just let something in, and we treat it aggressively with soaking, flushing, and antibiotics and go on our merry way.

However, if there are any radiological changes to the bone, indicating deeper infection, recurrence of the previous problem, anything like that, we could be headed back in for a second surgery, ten years after his first one, to modify that coffin bone again and scrape out the infection. He recovered well from that first surgery, but he was ten years younger, did not have Cushing’s, did not have a whole host of other old horse problems. Plus, he had a full coffin bone then. Now he’s got less to take from.

The in between would be step up aggressive treatment including regional perfusions of the limb, soaking, wrapping, cleanout, you name it. Hit it with everything we can to kill any possible infection and take lots of images of the foot in the meantime to make sure things have been halted in their tracks. That feels, right now, like the most likely scenario.

So, I have to say, wholly unexpected news. I figured we were in for some kind of nasty soft tissue thing, given that he was still swollen and warm after four days of standing wraps and stall rest. It literally never occurred to me that it might be an abscess.

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Writing through it

One of my goals for 2023 is to write more.

I used to write a lot – hundreds of thousands of words, literally. I could sit down and crank out a few thousand words like it was nothing. Like all unused muscles, that skill has atrophied over years. I can crank out an email – I can bullshit my way through a grant application – I can do some quick hit paragraphs for an object label. All of those I’ve been doing consistently in the last few years.

The deeper stuff, the ability to start going and keep on going, that’s faded away. I still spin stories in my head. I still write out articles, blog posts, short stories, all of it. I just freeze up when I sit down at a keyboard to translate it out.

Some of it’s attention span. I have so many things in my life, and so many things to cram into a day, that I too often prioritize things that can be done quickly. I hit the bottom of my email inbox and I feel like I’ve accomplished something, when I haven’t really. I wander around my house and put things away quickly rather than dig in on longer projects. There’s just always so much of it to do, and the short little things guarantee a dopamine hit. Little things that take me away from putting words down.

(case in point – while typing this post out, I checked Instagram and liked a whole bunch of posts about opening day in the Vermont Legislature, because my life is weird now and I have a lot of friends serving. it’s fun to hit like on those posts but it’s not writing!)

I’ve seen more than a few people in the horse blogging world lament that it’s not what it used to be. There’s a lot of reasons for that. I went through the first blogs -> Livejournal -> blogs cycle. (I still miss Livejournal…) The internet goes through its eras.

For me, though, blogging was never as much about commenting or getting comments. It was about writing through it. Writing through my bad days, my good days, my ongoing challenges, the things I was trying to puzzle out or figure out. It used to be that writing was a way of processing; summarizing the complicated weirdness of a recent vet visit helped me fix it in my mind. Building the narrative helped me cope. Without that exterior processing, I’ve lost the thread.

Here’s to getting it back in 2023.

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2023 Goals

Well, it’s that time. I’m turning 40 this spring, and that simple fact is doing quite a number on my brain. I’ve been thinking about this year’s goals for a few weeks now, reviewing what has worked in the past, reflecting deeply on values and what I want out of my life. Some things are still up in the air, but I feel more equipped than ever to work through them.

2023 energy: “just tried really hard to buck you off but had to settle for being a rockstar instead”

Obviously, I have loads of goals, but for this blog’s purposes, I’ll highlight a few of them. (I already talked a little bit about them last week.)

Write more.

  • blog every week (aiming for Wednesdays)
  • publish at least two articles
  • start drafting the Morgan book

Tristan

  • log every ride
  • hit goal of $X in farm saving fund (currently at 67.5% of that goal)
  • get more fit – get back to CrossFit 2x a week

General

  • begin downstairs bathroom renovation
  • organize & weed attic
  • improve Etsy shop numbers over 2022

In addition, I’ve set up a tracker of things I want to do every week. The idea is that active practice on a regular basis will more fully incorporate those things that I value into my life.

So, the categories of things that I will work on every week are: Tristan, writing, researching, CrossFit, house, and democratic organizing.

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Looking ahead to the new year

Well, then.

I had many goals this year, but life took me away from horse goals for a time. I’m a smidge sad, because I’ve had moments this year of feeling like I’ve been treading water in my riding for far too long. At the same time, I’ve accomplished a lot in other parts of my life, and my #1 goal remains accomplished: keep Tristan happy and healthy.

Still, I very much want to make some changes in the new year. In several areas of my life. I’m taking the first week of January, as I often do, by myself to do some reflection and planning. I’ll color in the lines more that week.

What do I have down so far to work on in the new year?

1. Write more. I feel keenly that I have not been writing much in my life lately. It so often falls between the cracks as the easy thing to put off and not worry about. I feel like my writing skills are rusty and slow, which is not a way I ever anticipated feeling. In the new year, I’ll be writing more, in a couple of places. This blog, for one. On my own research projects, for another. I’m also considering implementing a daily writing practice with a prompt.

2. Log every ride. I did this successfully in 2020 and 2021 and then just…didn’t in 2022. I have zero good reason why. I liked the time for reflection, the tangible way of recording the good and the bad, all sorts of things. No excuses for 2023.

3. Morgan research. Longtime readers are likely sick of hearing about the project that I always talk about but never manage to really pursue. I’m getting back to it in 2023. Regular, steady progress. I’ll blog here about some of the things I’m working on and the status of the overall project.

I’ve taken steps in the last few weeks to make the many pieces of my life more organized, among them some new technology to make work easier – a little iPad Air with a keyboard, a new Kindle Fire, and a thorough reorganization of my Google Drive.

I’ve also got some financial goals, as always. Some decluttering goals. Some fitness goals. Some political goals. Some leadership goals. Some really, really hard thinking to do about some major parts of my life that aren’t working right now. Let’s just say there is a lot of navel-gazing in my future.

Anyone out there have some goals for the new year?