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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?

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The Return of the Pivo

Well, here I am again trying to write more regularly!

This week, I pulled out the Pivo twice for my rides, after not using it in…more than a year? Time blurs these days.

Sunday’s ride was a short time up meant to get back in the saddle after three extremely long work days and see where he was ahead of our planned lesson on Tuesday. Well…he was somewhere, for sure. He squealed and cantered in hand after I finished setting up the Pivo, and then when I swung a leg over at the mounting block he reared up, leaped, you name it.

There followed a spicy, very “up” ride with a focus on loosening tension and stretching through the bend. With mixed results.

Twenty seven and one half years old, everyone.

My best guess is the change in season + recent hock injections really settling in + general contrariness. Either way, ultimately some good stuff, even if my position was so defensive as to be nearly useless by the end.

So then on to our lesson Tuesday! I had texted my trainer the images of the bucking (which she found hilarious) and so she was ready. And…he was lazy?

Until the last ten minutes. Then someone had the AUDACITY to make a loud Velcro noise while taking boots off a horse in the aisle and all bets were off.

The whole last ten minutes were snottiness interspersed with making him work his old man ass off. For example, the photos in the following sequence are, according to timestamp, seconds apart.

One immediate effect of watching the Pivo clips from Sunday: I worked hard to be less defensive in my position, stretching through my quads and having a softer elbow, and it mostly paid off immediately.

I am out of town at a leadership training for a few days and then back in the saddle on Sunday…I will definitely get the Pivo ready!

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Where we’ve been

Well, it’s been a while. So much for goals to blog more this year. Tristan and I are still here and still kicking along. I’d very badly like to write more (my brain needs an outlet that is just about ME) so I’ll give it a try.

In the meantime, some bullet points?

  • Tris is going great, we’re lessoning once a week and settled firmly into our “keep the old man limber and learning” pattern. Right now I’m fitting in 2-3 rides a week of ~30-40 minutes, and another grooming session or so. I expect & hope that to pick up in later November.
  • Healthwise, Tris is also still good! He’s had a couple of typical-for-him dumb scares that I may blog about in catchup mode, like the time he went three-legged lame overnight and then back to totally sound three days later, just in time for the vet. Or the time I spent $$$ to figure out he’s allergic to sheep & palm trees.
  • He is, however, 27 now and starting to show some old horse tendencies. Most recently around food; we’re using pill pockets to get his Prascend into him, and when I tell you I have tried every single horse pill pocket on the market I really mean every single one. He’s also getting picky about his grain in totally unpredictable ways. (Two days ago he quit eating his grain, and the barn manager tried a handful of the grain he refused to go near nine months ago and he demolished it?!) Just, stuff like that.
  • My life outside of the barn has spiraled out of control as I’ve been very deeply involved in local & statewide politics, working to get good candidates elected so we can get good policies that do things like fix the climate crisis and respect individual human beings’ dignity and autonomy and reset expectations about how everyone should work until they die but still not live comfortably. As you can imagine, it’s stressful and feels like rolling boulders uphill but it is also deeply invigorating and challenging and I seem to be good at it. I recently got a big fancy award and everything.
  • Work life is also nuts, with a promotion and a big federally-funded project and a partnership with a local university that has me teaching classes and oh also all of the other baseline stuff.
  • The house is…mostly just sitting there. We’ve done some small projects. But one room where we stripped wallpaper and then discovered it needed to be skim-coated is…still just sitting there half done. After nine months. Sigh. Maybe after the elections?

Anyway. Here’s hoping for more regular writing going forward!