Tuesday, December 25, 2007

daring to be the control group

Originally uploaded by Contrary Goddess.

My horse had a major injury. Not something like a broken leg or anything, but something that anywhere else anyone else would have called the vet and the vet would have sutured it, at least, and probably started systemic antibiotics and likely analgesics and put on stall rest and who knows what else.

When I saw it, it scared me. If this became infected, it could become life threatening. And it was in a bad place, just under the flank, in such a place that there was air under the wound. The hole, scratched in there by a horse in love with scratching himself after he’d managed to break off the top of the tree, was about the size of a quarter. There was already a small edema under his belly.

The wound was draining serus and blood, mostly serus. It was not infected. I disinfected it but with some caution too because I didn’t want to introduce infectious agents where there had been none and I didn’t want whatever I used to disinfect it to then inhibit the healing of the wound. For example, do you know to always rinse off hydrogen peroxide because the same oxidation that disinfects the wound also inhibits healing. Of course, you have to rinse with something sterile. Boiled water works. That’s what I used, H2O2 and then boiled H2O. I wondered whether I should even have done that. Then I applied black salve (ichthamol ointment) generously. Then I watched and waited and took his temperature (to check for infection) and his pulse (to check for pain) twice a day and watched some more.

He never moved any differently because of the injury, never showed any sign of pain or infection. He was outside in his field the whole time. The wound wept for several days. The edema grew. His temperature and pulse and attitude and appetite never changed. Then the wound started filling in, just a little bit. And the edema didn’t change. Then, one morning, about a week into the injury, the edema was smaller. The horse had been laying down and I thought maybe that was why it was smaller. But it never increased again so maybe that pressure is one way that edemas under the belly are reduced.

In two weeks the edema was gone. The wound had been closed for several days at two weeks and at three except for a slight star of scar tissue you couldn’t tell it had ever been.

Here is the thing -- people in general, and doctors/veterinarians in particular, don’t know what the natural course of an event, a pregnancy, a wound, whatever, is anymore. I came right up against that with my pregnancies, where an OB insisted that just about every woman he attended would have died without his intervention but when quizzed it became painfully obvious that he’d never seen a natural labor. To him natural labor meant induction, pitocin, epidural, episiotomy, traction, hemorrhage and everything else. Intervention is so common that it is the norm and there isn’t a control group of natural healing to compare it with.

What I did to the horse was intervention and honestly might not have been helpful intervention. I tried to use my judgment and do my best at the time but it might have been that I interfered as much as a veterinarian would have. And it might have been that a veterinarian’s care would have sped the wound’s healing by . . . a couple days maybe. Stitches would have meant it was closed sooner, but perhaps it being open wasn’t a bad thing. Do you see the assumptions that get made when we take over the role of the body? We don’t really know any of it.

There is a place for alopathic medicine. There is a place for holistic medicine. But there ought to be an even bigger place for allowing what will happen to happen. Including, eventually, death.

Where the line is is always the question. And it becomes a question of where we put our trust -- outside or inside?

Like so many of my posts, this one is really a question, not an answer. But my bias is always for the inside job.

My creation
Originally uploaded by Contrary Goddess.

These are wound photos at about 2 days, about a week, and about 2 weeks from date of injury.


eyemkmootoo said...

This is captivating "nuts and bolts" stuff that can't be gotten out of a book. Thanks for posting it.
And whatever season, or if you celebrate, I hope it finds you blessed.

Woody said...

My wife and I had a conversation along this thread a couple of days ago. She works in a lab at a hospital where the administration wants everyone to have a flu shot. Neither one of us has had, or believes in flu shots. I don't trust them. We talked about how those who advocated throwing anti-biotics at every little thing have created a monster of resistant bugs that we have no defense against anymore.

I appreciate your writing about treating the wound. It is wonderful to see the body heal naturally.


Ren said...

Here I sit with a cat tonight, that probably should see a vet but I keep thinking of this post and my usual ability to trust the natural process. When it comes to animals I have less trust because I have less knowledge.

I'll wait til morning and see how she's doing. Poor thing. I don't like seeing anything suffer, even if their body just needs to work through the process.

Ren said...

Score one for trust. The cat is doing fine now. :)

CG said...

While some things can be prevented (vaccinations are good), and other treated (antibiotics are good when used reasonably), mostly an animal kept company (which help keep it present) and warm will either get better or not of its own free will and I think, largely, that's the best we can do for them or us. I do not believe in euthanasia. Strongly.

Ren said...

I believe in it. But that's a whole different, lengthy discussion I'm sure. I've had two rats with tumors and put off euthanasia on the one until it ruptured and she suffered terribly. I think if something is for sure going to die, it's merciful. I would want the same choice for myself.

The cat looked like she was in terrific pain, but I could tell it was abdominal and she had no fever. I decided to wait, because it would either get worse or her body would pass whatever was blocking her up. It took her a while. I was nervous. But apparently my assumption of abdominal was right because she's back to her usual self. Phew.

I am curious as to why you don't believe in euthanasia. I think people should have that right even. Not for each other, but for themselves (which one really always has anyway, I just wouldn't want anyone having legal problems if I chose to do that...not that it's a choice facing me at the moment! Thank goodness.)

CG said...

People do have the right to kill themselves. And obviously I have no problem killing animals . . . to eat them, or to protect (for example) a garden. So that's not it.

I think people are wrong when they play God for something else. Have you not heard my story of the cat who was obviously dying, went to the vet to make sure, yes he said and the ONLY HUMANE thing to do is to kill it, but I said no, that's not our way, and we took it home and took photos and loved him and at night put him in the bathroom so the mess to clean up would be less and in the morning, every morning I knew he would be dead and about the 3rd or 4th morning instead he was eating. He lived another two years of good life and was killed by a tree falling on him evidently (we think we found his skeleton under a tree anyway).

The little goat who lived in my kitchen last year was dying. Supposedly. My mom was supposed to die about a week before she did. I think things have to make their peace with death and that sometimes that takes awhile. Most of what I don't believe in is the interruption of that process, and the assumption that because we are human and have the power that we should make that choice for that being.

Most animals have the ability to die from pain. If it is really too much. In fact, I think choice in death is totally there, so why take it on yourself? Because of your (universal "you" there) own fear of death.

Ren said...

Perhaps. I don't believe so though. I believe that it's exactly because I DON'T fear death that I believe euthanasia is a valid option. I don't believe extending life is optional all the time, I think we all die and is more time necessary? Depends.

Watching my rat sit there with her intestines hanging out made me feel as though I'd failed her by letting her hurt more than she needed to.

I have a hard time understanding how an animal that is being killed for food has come to peace with death, or how killing it is ok but euthanising an animal isn't.

If something is dying (and yet, we don't always know for sure) I'm ok with cutting off that suffering in some cases. I also like the idea of a living thing working through it's own death process. I just don't think it's a black and white right/ wrong issue. Depends.

I certainly believe that people should trust their own knowledge more than some medical "expert"...for themselves and their animals.