Week Nine – Unexpected Goodbye

Where to start…I was pretty sure this week was going to be pretty much straight forward. I was writing my notes up during a lull in chores on my Wednesday and thought to myself there wasn’t much to write about this week: there was Muffler and Diesel’s move into the big pool with Gasket, Spark Plug graduated from seal in tote to big girl in ODL 1, and the arrival of Chassis the Spectacled Eider. There was this tiny voice in the back of my mind saying, “Oh, I wouldn’t be so sure of that.”

Chassis came to us on July 11th from Nome, Alaska. Nome is famous for being the finish line of the Iditarod, the annual dog sled race that stretches over 1000 miles of harsh Alaskan wilderness. She had an open wound on her on her neck that exposed her wind pipe and esophagus. Chassis had been suffering from this wound for some time because the some of the tissue had dried out and was contaminated with sand. She was placed in a quarantine area inside of rehab and unlike Nozzle, we were the primary caretakers of this bird.

Since Chassis was contained in quarantine within quarantine we were required to shower out of rehab twice a day in order to care for her. We shower in to care for her and when we are finished we need to shower out in order to re-enter rehab. Her care is pretty basic. The new and old food needs to be weighed out. The deck needs to be sprayed down and her water drinker washed and re-filled. The hard part is netting her in order to force feed her fish that contains her medication. I am surprised I can catch her because there are many forces working against me: she’s a smart bird and she learns from every mistake I make, the net is damn heavy and cumbersome, and I have to straddle the deck of a 10 ft deep pool full of frigid water in the process. Chassis and I both work up a sweat, well that is if ducks could sweat. When I finally have her restrained I give us both a minute to catch our breath before I force feed her. That is the easy part. I ensure her wings and feet are firmly tucked close to her body and I use one hand to tip her head back until her bill opens. My finger slides down closer to the back of the mouth and with the other hand I insert the fish until her swallowing reflex kicks in and she swallows the fish down on her own. I let her go and that’s the end of her ordeal for the evening.

Friday was the first time I was to go in and do Chassis’s routine on my own. I was making good time. I was hoping to care for her and shower in and out in an hour. My roommate was coming by for a tour at 8:30 pm and I was right on schedule. I just happened to look in the rehab hallway and there was Piston on the floor being manually stimulated to breathe by Michelle…

I will not repeat the words I chose to utter to myself as I closed the door to the boot barn to put my boots on. There was a lot of, “Why? #$%@ Why?” He had been lethargic and had thrown up bile a few times that day, but he had never been considered that sick. His temperature had been normal that afternoon and his latest white blood cell count was normal as well. There was no indication that this was going to happen.

I finished with my choice words to myself and walked on to the scene and asked, “What can I do?” Michelle put me to task. It wasn’t long before Dr. Carrie and Elizabeth arrived. Piston’s temp was dropping and he wasn’t breathing. Both women snapped into action and we had Piston on heating pads on the crash cart in Tim’s office getting the oxygen hooked up. Fluid bags were being warmed in the sink to be placed in and around Piston to keep him warm. My role became apparent right away and I was set to keep a record of Piston’s vitals and the drugs being administered. There was that initial shock that Piston was crashing, but there was no time to dwell on it. We were trying to save his life and that was all that mattered in that room.

Some of the drugs being used were familiar like dopram and atropine. There were others that I was not. They were used in the same sequence and for the same reasons as with Buckle. We were assisting Piston’s breathing, but that didn’t seem like enough. So Dr. Carrie decided to intubate Piston. I was responsible for keeping a light on the back of the throat while the tube was being inserted. This is the opposite of tubing, here the tube is supposed to go down the trachea. Once the tube was fixed in place the machine was turned back on and he was getting a direct line of oxygen instead of oxygen just being pumped into a nose cone for him to breathe in. Dr. Carrie also decided to insert a catheter into Piston to aid in administering drugs intravenously. The first attempt failed, something just didn’t set right and the catheter tube was removed. She stopped to monitor vitals and observed the heart beat was weak but somewhat steady. She then set to inserting another catheter and this one was a success. I can’t recall if Dr. Carrie ever did inject anything into the catheter before checking Piston’s vitals once more. She checked his pupil dilation before she called his time of death. She explained that his dilated pupils indicated that he was already gone.

I immediately went into business mode and started cleaning up. I thought to myself, “No time to grieve. Things need to get done.” I tried to put on this crusty, bitchy exterior to keep people away and I set to checking on our other animals. I let the other intern cry and be comforted by others. I didn’t want to be comforted because if someone did I was going to crack. I finished my observations of the other animals and went back into the office to write in the records. I must have been really focused because I didn’t notice Elizabeth come in behind me. She placed her hand on my shoulder and asked how I was doing and that was it…

I turned to Elizabeth and blurted out, “He wasn’t supposed to get sick.” And I began to cry. It was true; he wasn’t supposed to get sick. Piston had been under our care for more than a month. All we had to worry about him was if we could get him eating fish and off of formula. This was a low blow. I felt like I was falling apart. This was not a thing I did. I wasn’t supposed to show emotion, that’s how it’s always been. I’m the middle child. I’m the one that had to keep it together. My sister was the baby and the sensitive one, my brother, the oldest dealt with things with his anger. I was the one to hold it together and I usually kept my emotions to myself.

I expressed this to Elizabeth and she pretty much threw my own words back into my face. Reminding me what I had said at the end of my post about Buckle’s death. [“Everyone grieves in their own fashion in this line of work ... That is how we can come back in the next day and the day after that and so on.”] It hurt. Was I not smart enough to learn from my own words? I had an unspoken bond with this animal, so why wasn’t I allowing myself to mourn his loss? The answer was I was conflicted. If I was serious about rehabilitation as a career choice I couldn’t have an attachment to the animals I treat or I would go through this each time an animal died. But I can’t be totally insensitive towards the animals I treat or why do this job at all?

I’m still fighting within myself about this issue. I’m not sure what the right answer is. I do know it will probably be a balance I will have to discover on my own. For now I have a new buddy I cuddle with at night… he’s a stuffed harbor seal named Piston.

Week Eight – Movin' on up

After my marathon of a post last week I thought I’d take it easy and give you all some updates on my progress and how the animals are doing.

So I’ve now graduated to tubing. Most of the other interns were chomping at the bit to try it, but I was very reluctant to give it a try. I felt I was just getting comfortable with restraining and then I was to be tossed into something that involves a lot more risk to the animal. I had received some instruction from the seasonal girls and Elizabeth about how to insert the tube, what to look and listen for, and how to withdraw the tube, but I still couldn’t help but think of the “What ifs?” What if I went down the trachea instead of the esophagus? What if I heard stomach sounds but was actually in the lungs? What if I didn’t pull the tube out properly and he aspirates formula? And so on. Luckily for me we went over these worst case scenarios and what to do when they present themselves. My fears were abated slightly but I had that nagging feeling in the back of my head.

On my Monday Tim took Laura and I out back to condoville and gave us our tubing tutorial. He talked us through tubing our first animal and then sat back and supervised us as we tubed our second seal. I seemed to do everything correctly. The seal was still alive when I was through. It was a success? Of course my confidence grew the more I tubed. Michelle was there watching over my shoulder for the next few days as I practiced the basics Tim had taught us. After I had that all down the next thing to focus on was style. Just like with restraining I got the basics down that everyone must do correctly and then I worked on how I open the mouth, how I hold the head and how I keep the mouth open for the tuber. I took things I liked about the seasonal girls’ style and made them my own. I also avoided things that others did that made me uncomfortable. I liked it when the tuber talked to me and told me what they were doing every step along the way. As a restrainer I had to focus on the animal and not on what the tuber was doing so it was nice when I was told that meds were being administered, or that formula was coming, or that she was crimping off the tube and pulling out. So I talk my restrainer’s ear off when tubing. I also worked on where I would crimp the tube, how many times I crimped before I pulled the tube out. Again the more I tubed the more I was comfortable with how I was tubing.

Well I wasn’t the only one moving on to bigger and better things… Gasket moved into ODL 5. This was the big pre-release pool area. Once we were confident in knowing Gasket was eating dead herring on his own and that he had a clean bill of health he was moved into the big house. I would guesstimate that the pool is 20 ft in diameter and no more than 10 ft deep, which meant lots of room for Gasket to swim around in. This move also meant he was getting less human interaction. As the kids move from the totes in the inside hallway, to condoville, to the ODL’s they receive less and less contact with us. As soon as the seals are on fish we minimize our contact as much as possible. Only entering the ODL’s twice a day to spray off the decks and throwing their fish over the fence or using the fish cannon system. The fish cannons are used in the big pool to eject fish right into the pool for the seals to eat. It is a series of heavy duty water hoses hooked up to the salt water system where we can drop a fish into the hose and the water pressure pushes the fish along the length of hose into the pool. Essentially Gasket is fed fish where we want him to be fed without him even seeing us.

During this past week we saw a new addition to rehab come in. A female Harbour Seal came to us from Homer. We had gotten a call from a network member in Homer about a pup alone on a busy beach. The mom was seen hanging around nearby, but the amount of people in the area prevented her from reuniting with her pup. The decision was made to pick up and transport the pup to us. She came in relatively good health (9.5 kg). She had some lacerations on her hind flippers, but other than that she was in great shape. Since she seemed relatively healthy I decided to name her before anyone else got a chance. I chose Spark Plug and everyone else seemed pleased with my choice. We started swimming her in the shallow 50/50 mix a few days after her arrival. Day by day she progressed to a higher water level and a water mix with less and less warm water. She seemed to take to the water like Gasket did and was very active during her swims. Spark Plug wasn’t even here a week before she was eating fish. She joined the ranks of our fish eating seals: Gasket, Muffler, Diesel, Gear, Manifold and Clutch. This left us with only three seals to tube: Piston, Wiper and Spring. I felt as if we were going to tube these guys forever and there they were growing up on us. Now I understand what is meant when a parent would say, “They’re just growing up so fast.”

Week Seven Part II - How to save a life...

Buckle continued to improve during my weekend. She had become active enough that the catheter had to be removed. We were ‘swimming’ her in a 50/50 salt/warm water mix that was just high enough to get her flippers wet. This is done to wash the urine and feces that we missed rinsing off and to promote bowel movements (more information than you wanted to know I’m sure).

When I came in on my Monday she was having a bit of breathing trouble and her temperature was elevated. We (as in me and another intern, Laura) continued on with the routine of the afternoon while the seasonal girls continued to monitor Buckle’s respiration rate and temperature. Elizabeth decided to drop in have a look at her as well.

Buckle had been closely monitored for a couple of hours when her vitals began to crash. Michelle and Elizabeth snapped into action and quickly had Buckle on the floor manually stimulating the seal to breathe and maintain a heartbeat. Elizabeth was prepping meds for injection from our ‘crash kit’ that contained a plethora of medications for saving a life (i.e., dopram, atropine, epinephrine, etc.). I was asked by Elizabeth to assist her in prepping these medications by keeping track of the meds being used and how much was needed. In the kit is a chart that outlines dosages for each drug and the dosage is dependent upon the weight of the individual. Some of the dosages were in fact ranges of amounts. This posed a problem. There was no one on site to consult. Our two resident veterinarians were out at the Steller Sea Lion colony helping to brand pups and were only available by satellite phone. Tim was absent as well at a network meeting in Homer. We were fortunate enough to reach both Tim and one of the vets by phone. The situation became highly intense with Michelle on the floor manually stimulating Buckle and calling out respiration and heart rates, Elizabeth on the sat. phone with the vet, and Laura on the phone with Tim relaying everything that was going on. And then there was me, like a deer caught in the headlights. I wasn’t sure of my role in the chaos. I had never been in a situation like that before. When I worked at The BCWP if we had an animal crash like Buckle did we would euthanize it. We didn’t have the same resources as The Center did and life saving drugs were not available to us. I felt as useless as a third nipple.

I kind of just did what was asked of me. I would cap needles for Elizabeth or get passed the phone and relay info to Tim or be the timer for respiration rates. At this point Buckle had received both a dopram injection to stimulate respiration and atropine to stimulate the heart. Her vitals continued to be irregular despite this. Her heart beat was infrequent, beating once every 30 seconds and her breathing had arrested. No one was able to get the oxygen up and running so the only alternative was to bag her. I was asked to breathe for Buckle using the bag and to pay close attention to her respiration. I had found a purpose among the chaos and I finally felt I was doing something for her instead of waiting for orders. I focused on only her and watched her mouth and nares for a breath. I would call out, “Breath!” every time she inhaled. I made sure I was depressing the bag at a steady pace. I was hoping I wasn’t missing anything and I was nervous about missing any breaths she may have taken. She was taking in air less and less despite my efforts. It wasn’t long before she stopped breathing altogether. Her heart stopped beating as well and Elizabeth prepared to inject her with epinephrine in a final attempt to save her. The epi was injected and I could see Buckle gasp and then nothing…

She was gone… We all sat with her tiny lifeless body out of respect for this creature and took a minute for ourselves. I silently wept to myself and caressed her head. I could finally touch her in a loving manner which was a bittersweet moment for me. I whispered an apology to her expressing how sorry I was that we could not have done anything more for her. I again looked for solace in the fact that we could learn from her and circumstances she came to us in.

Elizabeth sat down with Laura and me after talking to Tim and told us this was a great opportunity for us to examine a seal more closely than ever. So I did just that starting with her head. I opened the mouth and had a look inside: ran my fingers over her teeth and gums, probed the back of her throat, had a look at her tongue. I looked at her vibrissae and whisker beds, her eyes, examined her third eyelid and her ears. I next moved to her fore flippers and had a look at her nails and just how the joints all worked. Elizabeth brought out Buckle’s feeding tube, gave us a bit of a tutorial on tubing and we tried it for ourselves. Tim had suggested having us try a blood draw as well. So Elizabeth talked us through a blood draw: finding the proper site to insert the needle, how to redirect the needle and how to draw up blood. I was appreciative of the hands on education.

When we were finished, Elizabeth packed up the body and refrigerated it for necropsy. I had hoped I could be involved in Buckle’s necropsy. It would have brought the whole situation full circle for me. I was grateful when someone from vet services dropped the next day by to ask if any of us in rehab wanted to be involved in the necropsy. I eagerly shot my hand into the air and so did Laura.

Laura and I participated in the necropsy and we were responsible for cutting and labeling tissue samples. We got a candid look at what hyperthermia does to the internal organs. There was a notable amount of blood congestion in some of Buckle’s organs, most importantly in the brain. This was indicative of hyperthermia. Initially Buckle was exposed to excessive heat because she sat in an airport wrapped in a winter jacket in a poorly ventilated area for three hours. That heat essentially fried the part of her brain responsible for regulating body temperature. Buckle’s core temperature continued to rise, causing blood and fluids to be dumped into the vital organs. This caused the breathing problems; she had fluid in the lungs and the blood congestion seen in the organs. If the suspicions of her being septic were true then there was nothing we could have done for her. Her homeostatic mechanisms in her brain were totally damaged and was not able to fight this infection.

So there it was…closure. That was how I dealt with this unfortunate event. I needed to fully understand how and why Buckle died to cope with the loss. That was what happened with Axle as well. Getting to the heart of the problem gave their deaths a purpose, a reason why.

Everyone grieves in their own fashion in this line of work. Some will throw themselves into caring for the other animals. Some clean or occupy themselves with busy work. And some just cry. That is how we can come back in the next day and the day after that and so on.

Week Seven Part I – How to save a life…

I mentioned in my last post that we had two seal pups flying into Anchorage on my Wednesday. The pup we first heard about that was coming from Petersburg died during transport. The other seal that was coming in from Egegik arrived alive but she was clinging to life. Whoever prepared her for transport had packed her all wrong. She was kept in a Rubbermaid container which is standard for the smaller communities that cannot get their hands on a kennel. The problem was that there were too few air holes made in the sides and the lid. They also had her wrapped in a winter/thermal jacket for the 3 hour flight from Egegik to Anchorage. It was because of those circumstances that she arrived with a 106.2 F/41 C temperature and totally unresponsive. This is past the point where an individual is experiencing hyperthermia; where the core body temperature has been in an elevated state for an extended period of time, leading to organ failure, brain damage and death. This was our first seal pup to arrive in a critical state.

We worked hard to stabilize her with ‘round the clock attention. There were 4 am feedings. We administered sub-cu fluids multiple times a day and we were constantly monitoring her temperature. Her temperature eventually came down, but she still remained unresponsive and much like a ragdoll. She didn’t need to be restrained. I would just climb into the tote and kneel next to her and open her mouth for the tube to be inserted. I remember her face was crusty and her mouth dry. Her head was just dead weight in my hands. She could barely keep her eyes open. The vet had fixed a catheter to her spine in order to get quick blood draws and administer medication. We were drawing blood nearly every feed to monitor glucose levels and packed cell volume (PCV). We used the same kind of glucose monitor that diabetics use. By monitoring her glucose levels we were able to determine if we were providing her with enough energy to get her to the next feed since all she was being tubed was fluids. The PCV was looking at the ratio of blood cells to plasma which determined how hydrated she was. We were never worried about her pulling it out for the first few days because whatever position we placed her in was the same 3 or 4 hours later. Those first 48 hours were critical and I was fortunate enough to be a part of monitoring her progress during that time. I was asked to come in at 4 am to tube her fluids to get her through to morning. We also took her temperature and drew blood for analyses. I was surprised to see her holding her head up and somewhat undulating around. She was even resisting a little when we went to tube her. I thought to myself that things were looking up for baby girl.

To this point she was a critical case and we had been reluctant to give her a name. Since we were seeing signs of improvement, one of our volunteers that had gone to pick up this seal was given the opportunity to name her. She chose the name Buckle.

Week Six – Piston’s Tune-Up

I took some initiative last week and adopted Piston as my project. What was the objective of this task? To get him to eat fish! For the five days I was working I was responsible for swimming Piston with a variety fish to see what would interest him the most or maybe even eat.

Piston had been outside overnight in the condos for about a week and the allure of being able to swim in his pool when he so chose to had rubbed off. He had become a little lazy and stayed hauled out pretty much all day. I wanted to change that. So on my Monday I got the tote ready by cleaning it, filling it, and preparing fish. I chose for him 1 small whole herring (dead) and 2 small live salmon. Once those fish were in the tote I got Piston from his condo and plunked him right into the water. I began with swimming Piston in a ¾ full tote, but he showed no interest in chasing the live fish. I decided to drop the water line to under ½ full to allow him to chase the salmon with greater ease. It worked! He became more active and was tracking the salmon like a pro. He decided to spare the lives of the salmon and I returned them to their holding tank.

On my Tuesday I went through the routine of setting up the tote for Piston once again. I was curious to see what size of fish he preferred so I decided to go with 1 small herring (dead), 1 large live salmon and 1 small live salmon. I kept the waterline below ½ full and tossed him in. We had rigged the tote with an agitator hose that would create a current and keep the dead fish moving. This also meant the tote needed to be a flow through system with the agitator pumping water in, water also needed to flow out so the tote didn’t overflow. Unfortunately we lost the small live salmon which Piston had shown the greatest interest in to the out flow drain. He then concentrated on the large live salmon and started tracking that one, but not as vigorously as he had with the small guy. All the while the dead herring went unnoticed.

My hump day got a little busy. We got a call from Petersburg about a seal pup and arrangements were made to fly it in to Anchorage that evening. Again it turned into a 2-for-1 deal and we had another pup flying in this one from Egegik. Most of that morning was spent putting aside chores and preparing the rescue truck and rehab itself for these two seals. I didn’t get the opportunity to swim Piston.

After looking at what Piston had responded to during his pervious swims I decided on using 1 small herring, one small live salmon, and 2 silversides for my Thursday swim. He was pretty active but not interested in the fish at all. I think I netted a retarded salmon. The fish wasn’t really moving like a fish should even before I put Piston in the tote. I think this was what attributed to this lack luster swim.

My Friday arrived and I gave Piston one more shot. I had a bit of trouble regulating the waterline for his swim and he ended up being in a ¾ full tote. I put in 1 live small salmon and a cut up herring. I lost the salmon yet again to the drain which directed Piston’s attention to the herring pieces. This was really great because he had been ignoring the herring all week long. He ended up nosing them for a bit. This meant he was pushing the fish along with his nose and would occasionally mash it into the side of the tote. He spent the rest of his time in the tote actively swimming and I had time to reflect on the week and his progress. He didn’t make much but I was still satisfied he was learning a little more everyday about tracking and making steps towards getting that fish in his mouth. It’ll just take practice and patience on our part.