Tuesday, October 10, 2017

surgical wound care + bandages

I typically like to provide a little variety in the content presented here - usually avoiding too many posts in a row focused on the same subject.

As an eventer, this is relatively easily managed bc even if I'm just writing about one schooling ride or lesson after another, at least we've got three distinct phases to work on, right?

old shot from when we first moved in - but this shows the tack locker's general space blocking and storage capability
Right now tho, obviously Charlie is doing none of those phases. Rather, he is sitting in his stall looking bored and disinterested while nosing through the mountains of hay I can't stop myself from throwing at him.

And, perhaps you'll understand that this boring monotonous unchanging situation takes up the greatest portion of my attention and thoughts. It's on my mind, ya know?

So here's another post talking about Charlie's post-surgical care. This time, looking at the ungodly amount of material needed to keep his wound safe from infection -- and how I've updated the tack locker to accommodate all that.

top drawer clockwise from top L: sandwich baggies (for pre-measured supplements); freezer bags (for packing meals on the go); vet wrap; latex gloves; spare kitchen sponges; non-stick sterile pads; bandage kit inc. multiple sizes of rolls of guaze; and more variously sized non stick pads
First up on the chopping block: that nifty set of drawers needed to be cleared out and organized in a major way. It had over time grown into being a "catch all" space for small odds and ends that I didn't necessarily want to trash, but that weren't otherwise very utile.

Each drawer was fairly well stuffed, and the important stuff that I used most often was beginning to take up disorganized, stacked up residence on the floor space directly in front of the drawers (thus rendering the drawers less accessible).

So I finally threw out all the useless junk that I tend to hoard (OCD Brita was so proud of me!), clearing out some of the latest mice nests in the process (ew). Then I tried to think a little more deeply about how to restock the drawers in a way that makes sense and is useful.

Top drawer became: mostly baggies and bandage pads, and other boxed up medical stuff that didn't fit into the tool box described below. I hope to not need this drawer often, but do want to keep this stuff easily within reach should the need arise.

middle draw clockwise from top L: rolls of duct tape and clear packing tape; mini cordless clippers; tubes of bute paste; flash light; epsom salts; random mug bc why not; supplement tupperwares; SMZs; spray wound flush; half used tube of bute paste; alushield; furazone; bute tables; measuring spoons; ichthammol ointment; and baytril.
The second drawer is a little more cluttered but I'm hoping the shallow nature of the drawer will keep from letting it get overrrun. All my medications and topical treatments that aren't likely to leak are stored in here. Exceptions are the MTG, Animax, Betadine and Keratex that are stored in the hanging organizer.

A lot of the stuff here had been previously left out on the floor of the tack locker for easy grabbing when needed, but I'm actually happier to give them all a dedicated 'space.'

new stanley tool box - perfectly sized to nestle between the above set of drawers and the tack locker wall
I also picked up a new tool box that would ideally have enough space to fit a fair amount of goodies in it, while also being small enough to squeeze between the drawers and the wall. I had envisioned more of a fishing tackle box style, but this is shaped perfectly: long and wide but not very deep.

It doesn't really have many meaningful compartments, but that actually worked out well for my purposes. It's nice that the lid opens from either side and can come entirely off too.

absolutely filled with bandaging materials
I had planned to fill the box with more of the stuff that went into drawer #2 - all those medicines and ointments and whatnot - plus maybe the gloves and some rolls of vet wrap.

But actually it only fit a fraction of the bandages for Charlie's wraps so..... Yea I maybe was a little delusional about how much space this stuff really occupies.

In any case: the box holds my full supply of brown cling gauze, animalintex pads, telfa pads, elastikon, and most of my rolled gauze and vetwrap. All the rest of the vetwrap and non stick wound pads are in the top drawer.

omg and even more.... rolls upon rolls of cotton gauze and wraps
Naturally tho, there are other elements of Charlie's wound care supply that take up even MOAR room -- and are also maybe highly susceptible to mouse infestation. This would be the fluffy rolls of gauze and the big leg-sized rolled cotton wrap for encasing the whole cannon.

These goodies.... don't really fit anywhere and I've taken to storing them in my car for fear of the mice getting in there and making a poop-filled mess of things.

So.... yea. It's a lot of materials. Most of them are specifically devoted to Charlie's post-surgical wound care and will be used up in short order and not replaced at nearly the same volume. The rest tho are just every day first aid type stuff that's nice to have on hand. I imagine once a lot of the stuff in that tool box is used up, I'll be revisiting ways to pack it up to be a little more versatile.

the hospital bandage after 2 days. top two layers: blue vetwrap and elastikon at top and bottom to seal.
In the meantime, let's talk about the surgical wound and it's bandaging in particular. The vets at New Bolton changed the bandage the morning before he was discharged to make sure all was well - then left detailed instructions for care over the next two weeks.

The bandage is to be changed every 2-3 days. Early if it's wet, slipped down, or really nasty. Later if all looks well. In Charlie's case, the advantages of frequent changes (being able to visually assess the wound) are outweighed by the need to keep the site as sterile and clear from contamination as possible.

The top layer of the bandage is all about reducing the risks of contamination: a thick layer of vetwrap covers the entire bandage. And at each end, sticky elastikon seals the edges of the bandage directly to Charlie's knee and hoof. This creates a barrier protecting against anything slipping underneath the bandage.

middle two layers: brown cling gauze covering a full size cotton roll
The next layer of the bandage is essentially a standing wrap: thick rolled cotton covered by brown cling gauze. I'd never used this brown gauze before and am not totally sure what hugely important purpose it serves in existing between the cotton roll and the vet wrap.

But that's ok - I'm more than happy to do whatever it takes to keep that wound wrapped up like Fort Knox. The brown gauze is kinda nice too, as it sticks to itself relatively securely so you don't have to keep a hand on the bandage while gathering materials for each successive layer.

bottom layer: cotton gauze covering a telfa non stick pad
And finally, the innermost layer of the bandage - and arguably the most important: a non stick pad (in this case a Telfa pad) to dress the wound directly, held in place by a roll of cotton gauze.

The cotton gauze rolls from New Bolton are giant and fluffy and take up a ton of space compared to the vacuum sealed sterile rolls in some of the packs I've picked up (that you can see in the tool box pic), but again I'm not convinced there's a major difference. Both seem to work just fine, tho there's more volume to the hospital rolls. Like a big fluffy pillow lol.

the sutured up surgical site. chicks dig scars tho, right?
Below all that, we get to the wound itself. Idk. It's ugly. It's long and is closed by two different layers of sutures (for different tension relieving purposes) and definitely looks like a leg that has undergone some trauma. Poor Charlie.

i'll probably have this wrap figured out by the time i don't need to wrap it anymore lol
I'm not the world's greatest bandage wrapper but this whole situation seems mostly fool-proof. Plus it doesn't hurt that Charlie is an easy patient: he mostly keeps his leg pretty still when I'm working on it (tho all bets are off when I step away - he hates the feeling of a loose wrap and will shake and stomp the leg to make it come off. this is.... not helpful lol).

But it helps me feel a little better about the whole thing by getting all the materials organized and stored for easy access. Small wins, right? And maybe I'm not the only one who gets that odd self-satisfied feeling when looking at a freshly organized, well-stocked kit?

How have you gone about building out your first aid kits? By necessity bc of some major disruptive illness or injury? Or slowly over time as needs arose for this or that?

How do you keep things organized? Do you like everything to have its place, with similar items stored together? Or is it more a function of how often things get used? Is there any one item in your kit that you rely on head and shoulders above the rest? Or things you thought were very important that have gone unused for ages?

53 comments:

  1. I have a whole cupboard on the wall dedicated to medications/wormers/bandages etc. I can't imagine fitting it into a tack locker. That is one benefit to being home. The downside is that I don't worry about organizing neatly because of all the space....
    However, I LOVE that tool box- it's a perfect size. I'm going to look for one. Charlie's wound looks like it's healing well though.

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    1. I got that box from Amazon actually - https://www.amazon.com/gp/aw/d/B00GJYTXZO/ref=yo_ii_img?ie=UTF8&psc=1

      And yea I definitely know the feeling of having some much space to store stuff that organization can fall by the wayside. Sometimes I feel like that between my truck cap, trailer, tack trunk and now this locker (plus the overhead space above it lol). But it turns out I have a TON of stuff to cram into that space lol

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  2. Charlie's wound looks really good. I accumulated a bunch of stuff when Gem was hurt but I'm not an under organized person so it's a bit scattered. Having the hubby be a vet is great but it also lets me just assume we can swing by his place and grab whatever we need. Good for something minor. Probably not the best strategy when something major and acute happens.

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    1. Ha yea that's how it was at Isabel's barn : well stocked first aid supplies open to everyone so I never felt like I had to invest in a ton of my own stuff. Having a vet hubby would definitely help in that regard lol

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  3. holy cow. That is a lot of bandage stuff. I dont think i have anything in my box but some wound dressing and maybe an old roll of vetwrap. Not prepared at all....glad his wound looks so good.

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    1. Ha yup that sounds a lot like how I've operated over the past few years. It wasn't until I accidentally bought the King of the Dings that I really started collecting more advanced medical supplies haha

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    2. King of Dings. Love it :) HA HA HA

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    3. lol i call it like i see it ;P

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  4. That IS Fort Knox. Daggon.

    I love seeing the photos of your locker and organization. And hearing about the mouse nests! It's reassuring to see that it's common for things to get dusty yucky from a barn (shocking) and that other people have rodent issues, too. I have 3-4 mouse traps set in my tack locker at any given time to discourage the little bastards.

    I like things organized and everything in its place. My organization changes with time, and I like to think it improves. Of all of the things I've amassed over time, I use betadine + scrubs and Alu-Shield the most because the beasties seem to get more dings and cuts than anything else. Betadine helps guarantee cleanliness initially and then the AluShield helps provide a barrier against the world - mostly flies and gnats that keep the wound aggravated and prevent healing.

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    1. Ugh yea mice problems are real. And they seem particularly bad at the new barn - I've even got some in my truck now blargh. Also totally agreed on silver spray and betadine being some of the most versatile and immediately useful treatments. Tho annoyingly I bought betadine solution last time instead of the scrub and have decided I definitely prefer the scrub. Oh well, next time!

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  5. I don't have nearly as much stuff as I should. However, I also occasionally have a rodent problem and they'd probably make nests in the bandages so it's probably better if bandages live at the feed store 3 miles down the road... I do have a lovely bucket devoted to all things abscesses and then lots of ointments, creams, and goops, and stuff like that. But beyond lots of vetwrap, I'm really lacking on the horse bandages... But diapers? I have diapers and duct tape. And the miracle stuff that is white lightning.

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    1. ugh rodent problems are the worst :( it's definitely not worth buying all that stuff too if the mice are just gonna soil it all... i love the quintessential 'first aid bucket' too - tho always find that i wish i didn't have to empty the bucket out every time i wanted to use it. hopefully the drawers will help with that!

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    2. That's the problem with a walk out basement in the country (that also serves as my feed room). But, I'd rather rodents hit the basement than the main level (though now with 2 cats, that's not appealing either (though the kitties caught their first mouse a few weeks ago! No sign of any mice since anywhere. ::knocks on wood enough to scare everyone in the office::).

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    3. haha yea seriously. cats definitely help but when there's a barn involved.... i'm honestly not sure we can ever truly be rid of the little invaders.....

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  6. You are so organized and thoughtful in your care of Charlie's leg! My med kit has mostly been built off of various situations - so I own a lot of leg injury related items and some various wound care first aid. I actually considered selling off some of my standing wraps, which I immediately re-thought because Foxie went through the fence shortly after my brain formed the thought and reminded me why I have an entire bin of standing wraps. The tool box looks like a great idea, though... much easier to use than my current "bin I have to dig through to find anything".

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    1. ha thanks - the organization is all brand new, i promise -- almost all of these materials were just recently purchased in light of charlie's post-op care. and yea, you can never have too many standing wraps. they're such a pain bc they take up so much space - but especially after we lanced charlie's abscess and we were dealing with that drainage, it was very important to have a clean wrap on hand to bandage it every day. and if you're like me and only have a couple standing wraps... then that's a lot of laundry!! also agreed on hating needing to dig through a bunch of stuff to find anything - i'm hoping that the shallowness of the tool box and drawers will help prevent that

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  7. Thank goodness someone else doesn't understand the brown gauze either!! I was like, why do we need this?

    Very similar to Mikey's wrap, only mine came with the fight between OSU/us vs my vet as to how you should wrap a hock (cover the whole thing vs figure 8). The surgical team covered it, so in my book and trainer's, their unconventional way is correct. My vet lost her ever loving mind over it, wrapped him in a figure 8, and less than 8 hours later trainer had to redo it at night check because he managed to lay down on that leg and get the bandage pulled down hard on the top of the hock. Plus you know, it wasn't fully protected from dirt anymore.

    I had SO MANY BAGS. I used my huge Stanley show trunk as a medical supply trunk. It doesn't have compartments, so I had paper bags filled with each part of the wrap, and then various drugs. That way trainer could reach in from the top and get what she needed easily (normally I would do injury care, except his location and the timing of when I could rewrap made it a better idea for trainer to do it during the day).

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    1. ugh i'm so grateful that i only have to wrap a simple cannon wound as opposed to a big old joint like a hock!! that sounds stressful trying to deal with multiple experts who all strongly believe the wrap should be done differently. horse ppl, amiright? but yea that bag situation in the trunk sounds very convenient. if my trunk weren't already full of other junk (blargh) that would be my go-to idea too. as it goes tho, i'm the only one wrapping the horse so it only really matters that i know where everything is

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  8. This is actually a basically identical process to how I had to wrap Topaz's legs post-trauma (although I was wrapping all 4 and she was not nearly as pleasant about it as Charlie lol) -- and I have to admit I giggled a bit when you said you would probably have the wrap figured out about the time you didn't need it any more.... 100% true in my case 😂 you definitely have a much better organization set up than I did. Neat to see how you made the most of all that space in your locker!

    Hopefully Charlie is continuing to plow through his mountains of hay while his leg heals up!

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    1. ughhhhhh having to do this four times in a row for a non cooperative horse sounds like the most stressful thing in the world. esp with having to deal with storing all that material omg. now i just feel grateful to only have a single limb lol! thanks too - i'm hoping charlie will just keep sitting there peacefully getting fat while i sit around worrying myself sick over nothing.

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    2. In her defense she had a lot of super nasty lacerations so I think most of the uncooperative behavior at the beginning was because it hurt. She did get better once they healed up a but, but the first few changes were 2 (or 3) person jobs, haha. But yeah, it was a rough couple of months. Hopefully yours is much smoother sailing!

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    3. ugh yea, that sounds awful - esp with every leg so sore!!! can't really blame them when it hurts that bad, esp bc we can't really tell them that we're trying to help. charlie for his part i think has been exposed to so much poking and prodding (and potentially overly firm handling) at the track that he basically assumes the statue position whenever i'm down by his feet. it's.... helpful for sure, tho naturally i still occasionally fumble a bandage lol. ugh horses. it's always something!

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  9. Oh man this makes me realize that I probably should check in on m first aide supplies... It's kinda scattered to the winds but I at least know where the vet wrap and topical ointments are. After that...well I probably should reevaluate!!!

    One thing that I have that sat around collecting dust until this past week was a bag of diapers (no joke-they're old enough to have Shrek the 3rd babies on them) But Chimi decided to have the abscess from hell (it's never ending!!!!) and I've used more of those diapers in a week than I had ever used before. So yay for hording old diapers?

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    1. ugh yea i know that 'scattered' feeling but got completely sick of it when i couldn't find the roll of duct tape i *knew* i just had, and the brand new tub of ichthammol that i *just* bought. like.... nothing is more annoying than that. so. organization is the answer! also that's good to hear about suddenly finding an immediate need for all those diapers.... i've got a huge pack of them buried in that locker taking up space and begging the mice to stay away lol, it sure would be nice to see them eventually (tho not this wk plz dear dog) be put to use lol. hope Chimi is feeling better asap!

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  10. I love hearing about everyone else's medical kits:) I just put mine together at the new farm and it has many of the things you've mentioned above. My vet helped me put together a bandage/trailer drug kit with injectables too. It's so easy to get busy or to have an injury free horse and let things get messy and disorganized. I definitely love having everything in one spot to access easily!

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    1. yea i was super spoiled with isabel over the years since the most she ever really needed was the occasional spritz of silver spray. charlie is a whole 'nother can of worms tho and i'm tired of begging basic supplies from barn mates lol.

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  11. Ugh, seeing this brings back so many memories from Foster's surgery. I hate elasticon with a PASSION. It works, but getting it off and getting the residue off of the horse afterwards is a total bitch. Your wrapping skills look great though!

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    1. it's definitely messy stuff! i've never had to use it before so i'm still getting used to it. it STICKS lol. hopefully it won't be too much of a pain to clean out later....

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  12. Oh geez I'm a hoarder too lol. I hardly throw anything away. "I might use it later!" Yeah, that usually NEVER happens lol. I just recently went through stuff I had lying around and now need to go through a few more things. Probably grab some more drawers like you have lol.

    When Amber was injured my bandage looked so much like yours but a whole stack wrap all the way to the middle of her forearm since I had to cover the knee. One pillow wrap on top and one on the bottom... Yeah I got really good at those. You will too! It won't take as long as you think. I STILL have pillow wraps and brown gauze from that time 5 yrs ago - so I suppose that's a good thing since I haven't had to use it? The scar looks a little bad, but I think it'll heal nicely :). Horses have a way of surprising us in that. Looks like he's being a great patient, tho :).

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    1. ugh i hate those full leg wraps - we had to do that with charlie too for his cellulitis, tho fortunately not super long! and yea not throwing stuff away is definitely my weakness. sure there have been times when i've been grateful to have held onto something random that suddenly becomes useful again... but.... that's usually not the case lol!

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  13. good call on keeping the extra floofy stuff in your car. mice would LOVE that.

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    1. yea they already found quite a bit to love in my supplies drawers so i'm trying to be a little more proactive in keeping them OUT lol, bleh

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  14. My first aid kid is not nearly as robust since we have a barn one (and the tack store is right there too which is helpful). I do love keeping things organized though and have this cool tote in the bottom of my trunk from Target. It's a little beat up now and probably less organized since its a catch all at the moment.

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    1. yea i've always relied on the barn's own first aid supply closet wherever i've been. but i guess i just feel like things at the new place are a little more .... independent? idk it's hard to explain but i feel the least stressed when i know that i *personally* have everything charlie currently needs right now. also - yes i love totes in the tack trunk! anything that can help with organization! my trunk right now is a complete disaster so maybe that'll be the next project...

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  15. OMG you soon will be the world's best bandage wrapper, lol. I love a well organized first aid kit. I just never want to have to use it!

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    1. ugh seriously - the best thing about having all this stuff is hopefully the feeling of watching it get dusty from negligence!

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  16. I'm finally catching up with posts and awww poor Charlie ): It looks like he's getting top notch care though, sending thoughts for a speedy and uneventful recovery!

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    1. thank you! so far so good, we just gotta keep on chuggin!

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  17. Goodness, you're organized! I have a medium size tote full of medical supplies that I keep in the trailer, and just keep some basic stuff in the barn. Knock on wood, the medical tote is very dusty. You're going to be the resident expert on wrapping by the time it's all said and done.

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    1. nothing better than a dusty medical tote imho!!! i used to store a lot of the more important stuff in the trailer but now with the current set up the trailer is a little bit of a farther walk from the barn. but then again it's always nice to have that stuff when you're on the road too, just in case....

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  18. Looks like you've got quite the station set up! Hope Charlie continues to be a model patient for you! I am kinda spoiled since I board at home and my landlord/friend works at a hospital so our med 'kit' is ...um.... thorough. Endless sterile bandages, scrubs, needles, gloves, sprays, and washes. We are PREPARED. Luckily have not had to use it much... knock on wood.

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    1. haha yessss all that preparation is perfect tho for warding off any evil, right???? isn't that what the boy scouts say? or something!?!

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  19. I've slowly accumulated things. This reminds me: I need to grab some black duct tape. We have one horse in our aisle who has his legs wrapped EVERY SINGLE DAY. Forever. It's enough to make you cry

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    1. ugh seriously that sounds awful, poor pony! also tho, why just black duct tape? if it's pony related, i highly recommend going a little .... outre with it haha - as in charlie's flying pig duct tape wrap from way back when he had that hoof abscess lol. science says that fun duct tape makes the ponehs heal faster!

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  20. Surgery? Jeez what did I miss!! My kit was all over after my move but is back to being in one place again thankfully. Going to look for what I missed last week now...

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    1. ugh yea it's been a calamitous couple of weeks for charlie. that damned splint. blergh. it's gone now tho so, all crossables crossed, we just focus on moving on with life!

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  21. I have ended up reassembling my first aid kit with each new injury. I was also upfront with my vet when Nilla broke her leg. There was no way she'd let me wrap her leg on a daily/any basis and sedatives don't work on her so she got no stitches and just a no bow wrap to support the leg.

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    1. yea i can see how the organizational needs might change depending on the nature of the injury. and that's so hard with Nilla being not a very easy patient. definitely adds a whole new level of stress!

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  22. Your bandaging routine is exactly the same as Rio's was- and all the same supplies. I ended up buying a big rubber tote that I keep in our tack room for all his bandaging stuff- it's just SO MUCH. And I was buying more stuff every other week off Amazon and from the local feed store. I am still occasionally buying more stuff- but thankfully Rio's bandaging is now down to a minimum. I swear I spent over $300 in bandaging supplies after his surgery- but then again I had 2 surgical sites to wrap, so double the supplies. Good luck managing everything- and it looks like you already know to buy in bulk!!!

    -Kelly @ HunkyHanoverian

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  23. I love how organized everything is! This post has guilted me into cleaning out my locker tonight :P

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  24. I'm so impressed - what an intense process to wrap that bad boy. Your organization is prompting me to do something about my mess of a locker this week.

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  25. I usually reorganize all my first aid stuff every couple months. Things that I think I'll use the most--vet wrap, non-stick pads, furazone, what have you--go in a tupperware in the top shelf of my trunk while the pile of other crap goes in an old SmartPak drawer in the bottom of my trunk. And then of course as soon as I get everything swapped out and organized I usually need everything buried at the bottom of my trunk and nothing from the shelf because story of my life.

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  26. Wow, I really am behind in my blog reading! Poor you and Charlie, I know it's never easy to be sidelined for a while. I'm glad you were able to get to the bottom of it and have him surgically treated. Hopefully he heals well and that will be the end of it!

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