I haven't written in a while. I don't even know if anyone read this, but that's ok.
I have done SO much in the past month. I had my Prev Med rotation - short days and information I know a lot about, so it was enjoyable for me! I only completed 5 days of the rotation since I had to leave to go to Plum Island.
Plum Island was AMAZING. It was everything I could have wished for, and amazing people too! I got to touch and see animals with FMD (Foot & Mouth Disease), Exotic Newcastle (both viscerotrophic and neurotrophic), HPAI (highly pathogenic avian influenza), and African Horse Sickness. We spent a few days at Cornell, had a day off in Boston, and went to the island for 2 days. I couldn't have imagined a better time there!
After Plum Island, I had one week of vacation with Chris at the lake - it was wonderful, and I was happy to have time to spend with just the two of us without any other obligations.
I am currently on my small animal emergency/critical care rotation. It is a 4 week rotation full of lots of learning, lots of patients, and lots of stories you couldn't make up if you wanted to!
I had the first 2 days of the rotation off - everyone is randomly assigned a letter that corresponds to a schedule, and I think I got one of the best letters! I have one weekend day off each of the 4 weekends. Considering some people don't have any weekend days off, I think I'm pretty lucky.
I spent my first few days working in the ICU. When you're in ICU you do hourly patient care, which starts 30 min before the hour and usually finishes sometime after... sometimes, it's just in time to start the next hour's treatments! We were busy during the 2 days I spent in the ICU.
I am currently on ER. We have busy days and we have slow days. The most patients I've ever had in one day (so far, knock on wood) is 3. Saturday I had a neurologic dog with either tick paralysis or coonhound paralysis - we will only know which it is when I call the owners to find out whether or not she is making a recovery. She was non-ambulatory when she came in.
I've had some crazy owners that definitely made me laugh. When answering calls the other day I had a woman tell me her 10lb dog ate a frog that was still alive inside of it's belly. I like clients bc they make me smile.
They also sometimes make me very sad. Today I had the sweetest patient. She is a mixed breed dog who stole my heart. She can't walk or stand, but she smiles whenever you give her attention. After a short work-up, we were able to determine that she has multifocal neurologic lesions - likely in the brain and spinal cord. The owners opted to take her home for the evening for one last night together before euthanasia in the morning. It will be my first pet euthanasia. I hope they give her lots of love and lots of yummy treats tonight. I've already been crying - I don't know if this will ever get any easier.
Monday, June 28, 2010
Tuesday, May 25, 2010
Recent Thoughts.
As I return home from Iowa, everyone keeps asking me "How was it?!" to which I can only say "it was okay. I learned a lot."
What did I learn? I learned that I don't think I can work with pigs everyday for the rest of my life. Me? Not becoming a swine vet?! I know. I can hardly believe it myself. But, maybe I'm just not cut out for the job. Or, maybe the job isn't cut out for me.
I loved a lot of things about my trip to Iowa. I loved getting to know Kate - my roommate and hostess for the weeks I was there. I loved waking up everyday knowing I wasn't going to be sitting in a classroom. I loved the confidence I gained in being at a farm with other students without a clinician present. I loved the fact that I can cut open an animal and identify all of their internal structures without a problem. I loved not ever sitting around bored trying to waste time. I loved the experience, the knowledge, the pigs, and the people at Iowa State. I didn't love the job.
"WHAT!?!" has been the response I've gotten. "Why not?!" when I mention I don't think I'll work with pigs for my life. Well, for a lot of reasons. It was everything I thought it would be and everything I didn't want it to be.
I am a person who gives presentations to the community on what I believe in. I go out and present to the Lions, Kiwannis, etc Clubs in and around Columbus - to teach them how and why the pork industry raises pigs the way we do today. I love the pork industry, and I love everything positive that the industry has to offer. I believe that MANY producers respect their animals and love what they do. I believe that there are a lot of good people and families involved in raising pigs today.
I saw a lot of farms that were clean, organized, had great ventilation, and few sick pigs. I also saw a lot of different farms. Not everything was as wonderful as I would have liked it to be.
We spent a lot of time evaluating pigs, posting pigs, collecting samples, and disinfecting everything we brought with us. Because of the strict biosecurity on hog farms today, it was required that we wiped or sprayed (sometimes both) everything that came out of our vehicle at the farm. I completely understand this practice, and support cleaning of one's self and instruments before switching patients and facilities. However, I believe this is why I got so sick.
Somewhere between the Lysol and the few barns with poor ventilation, I lost my immune system. I was so sick I couldn't breathe. Dressed in disposable (non-breathable) coveralls everyday- some hot days, some cold days - with a mask on my face, wearing ear plugs, changing plastic boots between barns, euthanizing, cutting, and dragging pigs... I realized this wasn't what I loved.
I love the animals. I love the thrill of playing detective - finding the pig that represents the herd and evaluating it. I don't love euthanizing pigs. I don't like watching pigs die. And, I don't like way I felt (physically, mentally, and emotionally) at the end of everyday.
Tuesday, May 18th was the day I decided I wouldn't be able to work with pigs anymore. Tuesday was a long, hot, exhausting day. Tuesday I had a negative interaction with someone, and it was enough to push me over the top. Tuesday was a day that changed my life.
Here I am, home from Iowa. I had expected to meet people, but I never expected to find such a great friend in Kate. I expected to walk away even more excited about pigs than I had ever been, but I never expected I would walk away questioning whether or not I want to work with pigs or what my career path might be from here.
I am left with many questions, but I am also left with plenty of time to figure out what I love and what drives me. I have confidence that when I finish veterinary school next year, I will walk away with a love and passion for my job, whatever it may be.
What did I learn? I learned that I don't think I can work with pigs everyday for the rest of my life. Me? Not becoming a swine vet?! I know. I can hardly believe it myself. But, maybe I'm just not cut out for the job. Or, maybe the job isn't cut out for me.
I loved a lot of things about my trip to Iowa. I loved getting to know Kate - my roommate and hostess for the weeks I was there. I loved waking up everyday knowing I wasn't going to be sitting in a classroom. I loved the confidence I gained in being at a farm with other students without a clinician present. I loved the fact that I can cut open an animal and identify all of their internal structures without a problem. I loved not ever sitting around bored trying to waste time. I loved the experience, the knowledge, the pigs, and the people at Iowa State. I didn't love the job.
"WHAT!?!" has been the response I've gotten. "Why not?!" when I mention I don't think I'll work with pigs for my life. Well, for a lot of reasons. It was everything I thought it would be and everything I didn't want it to be.
I am a person who gives presentations to the community on what I believe in. I go out and present to the Lions, Kiwannis, etc Clubs in and around Columbus - to teach them how and why the pork industry raises pigs the way we do today. I love the pork industry, and I love everything positive that the industry has to offer. I believe that MANY producers respect their animals and love what they do. I believe that there are a lot of good people and families involved in raising pigs today.
I saw a lot of farms that were clean, organized, had great ventilation, and few sick pigs. I also saw a lot of different farms. Not everything was as wonderful as I would have liked it to be.
We spent a lot of time evaluating pigs, posting pigs, collecting samples, and disinfecting everything we brought with us. Because of the strict biosecurity on hog farms today, it was required that we wiped or sprayed (sometimes both) everything that came out of our vehicle at the farm. I completely understand this practice, and support cleaning of one's self and instruments before switching patients and facilities. However, I believe this is why I got so sick.
Somewhere between the Lysol and the few barns with poor ventilation, I lost my immune system. I was so sick I couldn't breathe. Dressed in disposable (non-breathable) coveralls everyday- some hot days, some cold days - with a mask on my face, wearing ear plugs, changing plastic boots between barns, euthanizing, cutting, and dragging pigs... I realized this wasn't what I loved.
I love the animals. I love the thrill of playing detective - finding the pig that represents the herd and evaluating it. I don't love euthanizing pigs. I don't like watching pigs die. And, I don't like way I felt (physically, mentally, and emotionally) at the end of everyday.
Tuesday, May 18th was the day I decided I wouldn't be able to work with pigs anymore. Tuesday was a long, hot, exhausting day. Tuesday I had a negative interaction with someone, and it was enough to push me over the top. Tuesday was a day that changed my life.
Here I am, home from Iowa. I had expected to meet people, but I never expected to find such a great friend in Kate. I expected to walk away even more excited about pigs than I had ever been, but I never expected I would walk away questioning whether or not I want to work with pigs or what my career path might be from here.
I am left with many questions, but I am also left with plenty of time to figure out what I love and what drives me. I have confidence that when I finish veterinary school next year, I will walk away with a love and passion for my job, whatever it may be.
Sunday, May 16, 2010
corn fed, country raised
i can hardly believe i've already been in iowa for a week!
things here have been fantastic. we went to farms on monday, tuesday, and thursday. wednesday was set as downtime in between farms, and we were able to have our "orientation" (just a few days into things...)
the farm we visited on thursday was much smaller than the ones we were at earlier in the week. monday and tuesday we saw barns with 1500 pigs/barn, giving 15,000 pigs on one site. the weather was less than ideal, but the pigs were seemingly content in the barns.
tuesday was my birthday. tuesday was also the first time in my life i euthanized an animal. the pig i euthanized was sick and was almost septic. after humanely euthanizing the pig, i posted it. the necropsy revealed that there was a strangulating intestinal hernia and the pig was unable to move any food through it's intestines. it was very interesting to see, and i learned a lot from this experience.
thursday was our first day by ourselves. i am in a group with kate (my hostess with the mostest here in ames) and seth (a student from penn), and it was just us. we were responsible for thorough evaluation of all of the barns on-site, and if any pigs were experiencing disease we were responsible for posting representative pigs and collecting sample tissues. lucky for the pigs, none of them appeared to be sick and we only needed to draw blood for PRRS status testing.
friday the 3 of us worked together (at the school) to put together a powerpoint presentation for the group of our findings from the previous day. we also had to write a case report. our presentation went well, and led to discussion of challenges producers face with managing large (or small) scale swine operations.
we had the weekend to ourselves, and it was delightful. i couldn't have asked for better hosts! kate and phillip are great, and i'm incredibly thankful to have stayed with them this past week.
tomorrow morning, the 5 students will head to minnesota where we'll stay for the week. there is a production system that is experiencing some issues that we need to help evaluate. still split into our teams, we are responsible for going to upwards of 30 farms in 4 days between the 5 of us. we are to collect samples and evaluate each site. it's quite the opportunity and i'm very excited to go there! this is the best hands-on rotation, and i can't imagine not coming here for it!!!
things here have been fantastic. we went to farms on monday, tuesday, and thursday. wednesday was set as downtime in between farms, and we were able to have our "orientation" (just a few days into things...)
the farm we visited on thursday was much smaller than the ones we were at earlier in the week. monday and tuesday we saw barns with 1500 pigs/barn, giving 15,000 pigs on one site. the weather was less than ideal, but the pigs were seemingly content in the barns.
tuesday was my birthday. tuesday was also the first time in my life i euthanized an animal. the pig i euthanized was sick and was almost septic. after humanely euthanizing the pig, i posted it. the necropsy revealed that there was a strangulating intestinal hernia and the pig was unable to move any food through it's intestines. it was very interesting to see, and i learned a lot from this experience.
thursday was our first day by ourselves. i am in a group with kate (my hostess with the mostest here in ames) and seth (a student from penn), and it was just us. we were responsible for thorough evaluation of all of the barns on-site, and if any pigs were experiencing disease we were responsible for posting representative pigs and collecting sample tissues. lucky for the pigs, none of them appeared to be sick and we only needed to draw blood for PRRS status testing.
friday the 3 of us worked together (at the school) to put together a powerpoint presentation for the group of our findings from the previous day. we also had to write a case report. our presentation went well, and led to discussion of challenges producers face with managing large (or small) scale swine operations.
we had the weekend to ourselves, and it was delightful. i couldn't have asked for better hosts! kate and phillip are great, and i'm incredibly thankful to have stayed with them this past week.
tomorrow morning, the 5 students will head to minnesota where we'll stay for the week. there is a production system that is experiencing some issues that we need to help evaluate. still split into our teams, we are responsible for going to upwards of 30 farms in 4 days between the 5 of us. we are to collect samples and evaluate each site. it's quite the opportunity and i'm very excited to go there! this is the best hands-on rotation, and i can't imagine not coming here for it!!!
Monday, May 10, 2010
PIGS... i love pigs!!!
i am so very happy to be in iowa!!!
today was cold. today was wet. today there were 40 mph winds and sleet hitting my face while i stood outside learning how to post a pig. today i did what i love. today i was filled with the enthusiasm of a 5 year old in a candy store. today was miserable. and yet, today was everything i could have dreamed of, and more!
kate and i rode to school together today - i'm certainly glad that we did bc iowa state's vet school campus is confusing. not to mention, it's currently under construction and therefore even more complicated than need be.
we had a BRIEF orientation and signed away our lives to voluntarily swab our nostrils before and after every farm visit so one of the researchers here can track whether or not humans are able to carry anything from the farm in their nostrils... without much further knowledge, i can't explain it any better.
next, we packed up and headed to the farm. upon arrival, each student was assigned a barn and we were to critically evaluate and record our findings. after our walk-throughs of the barns we met up with the group again. because not everyone had finished, a few of us were assigned a second barn. after finishing both of my barns it was time to learn how to post a pig. (posting a pig, by the way, means essentially cutting open a freshly dead pig to inspect it's organs and body systems to analyze a potential cause of disease - it's similar to an autopsy on a human, but done on the farm). after learning how to collect samples properly, the wind picked up to insane speeds and began throwing the rain and sleet in our faces. we moved indoors to snare and bleed pigs. (bleeding a pig, by the way, just means collecting blood from it). we each had to bleed 10 pigs and snare 10 pigs for one of our rotation-mates. i excelled. i love bleeding pigs. when i worked in the research lab, we used to collect hundreds samples from pigs. i can bleed pigs confidently, and i did. because our group finished first, we were given the task of teaching a shadowing 2nd year vet student how to bleed pigs. we did this quickly, and she was an expert bleeder in no time at all! after that, the weather began to clear up (by clear up i mean the sleet had stopped and the wind was probably down to 30mph). we were given the option of posting one pig per student. i jumped at the chance, and kate and i were the first students to post our pigs.
my pig died of congestive heart failure. the inside of the body was a fantastic sight. kate's pig likely died of a chronic infectious disease. that's all i'll say, without too many details. i will also refrain from posting any pictures from such events, though it's by far the coolest thing i have done since i started clinics.
tomorrow, we teach. we will have a group of 22 2nd and 3rd year vet students, and we will teach them how to post pigs (in small groups), snare and bleed pigs. i can't wait! two of my favorite things combined into one day... teaching and pigs. i couldn't ask for a better birthday present.
today was cold. today was wet. today there were 40 mph winds and sleet hitting my face while i stood outside learning how to post a pig. today i did what i love. today i was filled with the enthusiasm of a 5 year old in a candy store. today was miserable. and yet, today was everything i could have dreamed of, and more!
kate and i rode to school together today - i'm certainly glad that we did bc iowa state's vet school campus is confusing. not to mention, it's currently under construction and therefore even more complicated than need be.
we had a BRIEF orientation and signed away our lives to voluntarily swab our nostrils before and after every farm visit so one of the researchers here can track whether or not humans are able to carry anything from the farm in their nostrils... without much further knowledge, i can't explain it any better.
next, we packed up and headed to the farm. upon arrival, each student was assigned a barn and we were to critically evaluate and record our findings. after our walk-throughs of the barns we met up with the group again. because not everyone had finished, a few of us were assigned a second barn. after finishing both of my barns it was time to learn how to post a pig. (posting a pig, by the way, means essentially cutting open a freshly dead pig to inspect it's organs and body systems to analyze a potential cause of disease - it's similar to an autopsy on a human, but done on the farm). after learning how to collect samples properly, the wind picked up to insane speeds and began throwing the rain and sleet in our faces. we moved indoors to snare and bleed pigs. (bleeding a pig, by the way, just means collecting blood from it). we each had to bleed 10 pigs and snare 10 pigs for one of our rotation-mates. i excelled. i love bleeding pigs. when i worked in the research lab, we used to collect hundreds samples from pigs. i can bleed pigs confidently, and i did. because our group finished first, we were given the task of teaching a shadowing 2nd year vet student how to bleed pigs. we did this quickly, and she was an expert bleeder in no time at all! after that, the weather began to clear up (by clear up i mean the sleet had stopped and the wind was probably down to 30mph). we were given the option of posting one pig per student. i jumped at the chance, and kate and i were the first students to post our pigs.
my pig died of congestive heart failure. the inside of the body was a fantastic sight. kate's pig likely died of a chronic infectious disease. that's all i'll say, without too many details. i will also refrain from posting any pictures from such events, though it's by far the coolest thing i have done since i started clinics.
tomorrow, we teach. we will have a group of 22 2nd and 3rd year vet students, and we will teach them how to post pigs (in small groups), snare and bleed pigs. i can't wait! two of my favorite things combined into one day... teaching and pigs. i couldn't ask for a better birthday present.
Sunday, May 9, 2010
goodbye, cardio... hello, iowa and pigs!
I very much enjoyed my first week of Cardiology! I saw some of the most amazing cases... from a dog getting a re-check after his Tetralogy of Fallot surgery to a pacemaker put in my patient's heart, I learned a lot! I couldn't possibly have enjoyed Cardio more than I did in week 1. I wish I had written about it when I was in the middle of it and could portray the excitement I had during that week. Dr. Scansen is an amazing clinician and teacher, and I really enjoyed learning from him. Dr. Kent is incredibly personable, and though I had all of my cases with Dr. Scansen, I enjoyed working around her too.
Week two was anything but enjoyable. I spent my days upset, hurt, and worst off - in tears. The clinicians really make a difference. Despite the ups and downs, I learned a lot on Cardiology and am glad I didn't opt out of it.
I was truly terrified of the rotation before I took it, but have since come to terms with the fact that I feel confident in my ability to hear and at least give differentials for murmurs depending on their sound and location.
I arrived in Iowa this evening, after a 10 1/2 hour drive here today. I am exhausted, am finishing up some powerpoint slides (136 of them to be exact) that are due for tomorrow morning, and going to bed. I'm staying with Kate and her husband. Kate and I are both on the swine rotation these 2 weeks - I'm excited to spend some time doing something I love.
(pictures from the 2 weeks of cardio to come soon)
Week two was anything but enjoyable. I spent my days upset, hurt, and worst off - in tears. The clinicians really make a difference. Despite the ups and downs, I learned a lot on Cardiology and am glad I didn't opt out of it.
I was truly terrified of the rotation before I took it, but have since come to terms with the fact that I feel confident in my ability to hear and at least give differentials for murmurs depending on their sound and location.
I arrived in Iowa this evening, after a 10 1/2 hour drive here today. I am exhausted, am finishing up some powerpoint slides (136 of them to be exact) that are due for tomorrow morning, and going to bed. I'm staying with Kate and her husband. Kate and I are both on the swine rotation these 2 weeks - I'm excited to spend some time doing something I love.
(pictures from the 2 weeks of cardio to come soon)
Monday, April 26, 2010
long week. long day. hello, cardio!
so, as i leave the world of equine, i'll do a quick look back at the past week...
cases i saw and treated included: rectal tear in a pony, septic foal times 3, colic times who knows, salmonella horse, diarrhea in foals, guttural pouch mycosis, a fractured foal leg, a deep laceration, a miniature cow in labor, a baby reindeer, and last but not least... this morning's 4am equine dystocia! dr. mudge commented on friday that the only horse emergency we hadn't seen was a dystocia and that we needed one this weekend... well, we got one! and i got called in for it (well, i got called in because the tech ruth is essentially the most inefficient person i've ever met but that's another story)...
below are all of the pictures from the end of my equine emergency rotation as well as pictures of my first cardio patient today - a jack russell terrier with severe pulmonic stenosis and tricuspid dysplasia (thanks, allison, for helping me pick my case - you're the best!) adam and i rocked out patient #1 on cardio! :) wahoo!
miniature cow and calf
catheter i placed on an emergency case
radiographs of a horse chest
mama reindeer and baby (who i gave multiple treatments to!)
giving a K Pen injection... because this takes at least 10 minutes to give, we had plenty of time to take a picture!
Sam & Amy in isolation
cutest little foal to ever exist... I LOVEEEEE HER!!
on Equine ICU overnights you also take care of any in-house food animal cases (ie making a weak calf nurse every 2 hours)
gigantor foal!
my equine ICU group, including Dr. Mudge! <3
best. picture. ever. my last hours of equine ICU... those are all of the doctors with chains on the foal (stillborn) to pull it out of the mare while allison and i held the mare...
arrive at school at 4:30am... assist with mare dystocia... by 7:30am head to cardio for an entirely different set of patients and topics... 14 hours put in at school today on 2 rotations...
i love veterinary medicine!!!!! <3
cases i saw and treated included: rectal tear in a pony, septic foal times 3, colic times who knows, salmonella horse, diarrhea in foals, guttural pouch mycosis, a fractured foal leg, a deep laceration, a miniature cow in labor, a baby reindeer, and last but not least... this morning's 4am equine dystocia! dr. mudge commented on friday that the only horse emergency we hadn't seen was a dystocia and that we needed one this weekend... well, we got one! and i got called in for it (well, i got called in because the tech ruth is essentially the most inefficient person i've ever met but that's another story)...
below are all of the pictures from the end of my equine emergency rotation as well as pictures of my first cardio patient today - a jack russell terrier with severe pulmonic stenosis and tricuspid dysplasia (thanks, allison, for helping me pick my case - you're the best!) adam and i rocked out patient #1 on cardio! :) wahoo!
miniature cow and calf
catheter i placed on an emergency case
radiographs of a horse chest
mama reindeer and baby (who i gave multiple treatments to!)
giving a K Pen injection... because this takes at least 10 minutes to give, we had plenty of time to take a picture!
Sam & Amy in isolation
cutest little foal to ever exist... I LOVEEEEE HER!!
on Equine ICU overnights you also take care of any in-house food animal cases (ie making a weak calf nurse every 2 hours)
gigantor foal!
my equine ICU group, including Dr. Mudge! <3
best. picture. ever. my last hours of equine ICU... those are all of the doctors with chains on the foal (stillborn) to pull it out of the mare while allison and i held the mare...
arrive at school at 4:30am... assist with mare dystocia... by 7:30am head to cardio for an entirely different set of patients and topics... 14 hours put in at school today on 2 rotations...
i love veterinary medicine!!!!! <3
Sunday, April 18, 2010
tired, but happy! i love owners!
I worked from 8am-8pm today... technically I was at the hospital about 13 hours, but who's counting?
For the first time, I worked with an owner today! Oh, she was so sweet! She brought us a brunch cake, strawberries, and grapes - and she just adores her horses. She has a mare in the hospital right now for a rectal tear, and she and the mare are both just the sweetest. I worked with her horse as much as possible today, partially because I enjoyed working with the woman so much and partially because I adored her little mare. I braided a horse tail today for the first time, and I must say it looked pretty darn good!
We stayed plenty busy all day, even without any emergencies coming in. The girls overnight last night had a bit of a crazy and hectic night complete with colic surgery on a gelding that arrested! After about 7 minutes of trying everything they could think of, they horse's heart started beating on it's own again and about 20 min later it started breathing on its own! He looked great today, and I was pretty glad to see that he was feeling better throughout the day.
It was a good day, overall. I just love the equine vets at the hospital - some of the techs are equally as wonderful to work with. I think I'm really going to miss working with horses...
For the first time, I worked with an owner today! Oh, she was so sweet! She brought us a brunch cake, strawberries, and grapes - and she just adores her horses. She has a mare in the hospital right now for a rectal tear, and she and the mare are both just the sweetest. I worked with her horse as much as possible today, partially because I enjoyed working with the woman so much and partially because I adored her little mare. I braided a horse tail today for the first time, and I must say it looked pretty darn good!
We stayed plenty busy all day, even without any emergencies coming in. The girls overnight last night had a bit of a crazy and hectic night complete with colic surgery on a gelding that arrested! After about 7 minutes of trying everything they could think of, they horse's heart started beating on it's own again and about 20 min later it started breathing on its own! He looked great today, and I was pretty glad to see that he was feeling better throughout the day.
It was a good day, overall. I just love the equine vets at the hospital - some of the techs are equally as wonderful to work with. I think I'm really going to miss working with horses...
long days...
Sam and I had another patient the other day. It was our first SOAP, as he stayed at the hospital. He was a warmblood, presenting for colic. I was able to place his jugular catheter as well as the nasogastric tube - but he was so tall that I was on my tippy toes for part of it!! Sam was so sweet in letting me pass the tube. She's one of the nicest equine people I know - she's always letting me do things so I can learn since she's done a lot of it before, and I definitely appreciate that.
We ended up getting sent home early Friday night because there were 4 or 5 Columbus State tech students and not a lot of in-house patients so they were able to take care of all of the treatments themselves.
The hardest part of this rotation has been adjusting to this time schedule. I'm working 8am-8pm today and then am on midnight to 8am the rest of the week... I'm sleep already!
We ended up getting sent home early Friday night because there were 4 or 5 Columbus State tech students and not a lot of in-house patients so they were able to take care of all of the treatments themselves.
The hardest part of this rotation has been adjusting to this time schedule. I'm working 8am-8pm today and then am on midnight to 8am the rest of the week... I'm sleep already!
Friday, April 16, 2010
I had my first patient... and she went home alive :)
It's been a long few days, and I can barely keep track of my days anymore.
Tuesday, about an hour after coming home, I got called in and was at school till 1am doing midnight treatments. I enjoyed working with Amy and Sam - it was Amy's first day, and so I'm glad I went in since Sam was still scrubbed in to the colic surgery.
We did the routine treatments on all of the in-house critical care cases. We milked some mares (done either to keep them to continue producing milk for when the babies can nurse or to feed that milk to the babies through a nasogastric tube.
Wednesday, I had my first patient! It was an older mare presenting with respiratory distress. She had a few month history of coughing and a heart murmur. While not good for the horse, it was very easy to hear (and feel) the murmur and the lung sounds. I was able to ultrasound her heart and lungs, which was pretty neat to do! We took some radiographs, looked at the lung pattern, and decided the treatment. We sent her home on steroids, antibiotics, and recommended meds for the murmur. I got to sign (and write) her discharge papers! She went home, and though she doesn't have a good prognosis, she's only being used as a pasture pet and will hopefully enjoy the rest of her life comfortably!
These 16 hour days are wearing on me. I'm nearly finished helping at the Franklin Co Emergency Management office, though... YAY!
Tuesday, about an hour after coming home, I got called in and was at school till 1am doing midnight treatments. I enjoyed working with Amy and Sam - it was Amy's first day, and so I'm glad I went in since Sam was still scrubbed in to the colic surgery.
We did the routine treatments on all of the in-house critical care cases. We milked some mares (done either to keep them to continue producing milk for when the babies can nurse or to feed that milk to the babies through a nasogastric tube.
Wednesday, I had my first patient! It was an older mare presenting with respiratory distress. She had a few month history of coughing and a heart murmur. While not good for the horse, it was very easy to hear (and feel) the murmur and the lung sounds. I was able to ultrasound her heart and lungs, which was pretty neat to do! We took some radiographs, looked at the lung pattern, and decided the treatment. We sent her home on steroids, antibiotics, and recommended meds for the murmur. I got to sign (and write) her discharge papers! She went home, and though she doesn't have a good prognosis, she's only being used as a pasture pet and will hopefully enjoy the rest of her life comfortably!
These 16 hour days are wearing on me. I'm nearly finished helping at the Franklin Co Emergency Management office, though... YAY!
Tuesday, April 13, 2010
Equine ICU is definitely different than ambulatory...
I am now 2 days in to my Equine Emergency/ICU rotation.
Yesterday, we had orientation from 4-6, which is the normal time for rounding everyday. After that, Melissa and I were assigned to work, with Sam on back-up. For learning's sake, Sam stayed with us for the evening - I'm really enjoying working with Sam so I was glad she stayed!
We spent the first few hours trying to figure out everything needed for treatments of the horses. There are currently a decent number of horses in the hospital. There are 2 sets of mares and foals in our NICU and then 2 more sets of mares and foals in Isolation (one set went home today - yay for them!!). Needless to say, it was a bit stressful figuring out where everything was (meds, syringes, needles, hay, grain, hoses, etc) but once we got the swing of things it was ok!
Because everyone covers all of the cases collectively, none of the cases are "mine" and also, none of the cases really belong to Emergency - they all belong to either Medicine or Surgery. It's kind of confusing to figure out everything, and even more confusing to keep track of it all!
Today in rounds, however, we each had to present a case. I picked a 16yo Thoroughbred gelding who presented on 4/5 with colic. He went to surgery and had a jejunocecostomy. Two days later, he was colicky again and went back to surgery. This time he had torsed just orad (towards the head) to the previous anastomosis. He has recently been put back on feed, but wears a muzzle when not eating to prevent him from eating the straw in his stall. Last night he began flank watching (looking at his side), so today some additional work-ups were done. On ultrasound there was normal distension of his small intestines and normal peristalsis. On rectal, he was found to have soft, passable feces with no abnormalities noted. He is currently on metaclopramide (to keep things moving) and banamine (for pain). He pooped just before I left the hospital today at 6pm!
I'm on back-up tonight... so I'll keep my phone handy. I wouldn't mind going in and working with Amy & Sam, but I'm also pretty exhausted! I'm spending my days this week and next at the Franklin County Emergency Management and Homeland Security office writing and working on the Animal Emergency Response Plan for the county (it can't leave the office, and office hours are 8-5... this is the only time I can do it!)...
Yesterday, we had orientation from 4-6, which is the normal time for rounding everyday. After that, Melissa and I were assigned to work, with Sam on back-up. For learning's sake, Sam stayed with us for the evening - I'm really enjoying working with Sam so I was glad she stayed!
We spent the first few hours trying to figure out everything needed for treatments of the horses. There are currently a decent number of horses in the hospital. There are 2 sets of mares and foals in our NICU and then 2 more sets of mares and foals in Isolation (one set went home today - yay for them!!). Needless to say, it was a bit stressful figuring out where everything was (meds, syringes, needles, hay, grain, hoses, etc) but once we got the swing of things it was ok!
Because everyone covers all of the cases collectively, none of the cases are "mine" and also, none of the cases really belong to Emergency - they all belong to either Medicine or Surgery. It's kind of confusing to figure out everything, and even more confusing to keep track of it all!
Today in rounds, however, we each had to present a case. I picked a 16yo Thoroughbred gelding who presented on 4/5 with colic. He went to surgery and had a jejunocecostomy. Two days later, he was colicky again and went back to surgery. This time he had torsed just orad (towards the head) to the previous anastomosis. He has recently been put back on feed, but wears a muzzle when not eating to prevent him from eating the straw in his stall. Last night he began flank watching (looking at his side), so today some additional work-ups were done. On ultrasound there was normal distension of his small intestines and normal peristalsis. On rectal, he was found to have soft, passable feces with no abnormalities noted. He is currently on metaclopramide (to keep things moving) and banamine (for pain). He pooped just before I left the hospital today at 6pm!
I'm on back-up tonight... so I'll keep my phone handy. I wouldn't mind going in and working with Amy & Sam, but I'm also pretty exhausted! I'm spending my days this week and next at the Franklin County Emergency Management and Homeland Security office writing and working on the Animal Emergency Response Plan for the county (it can't leave the office, and office hours are 8-5... this is the only time I can do it!)...
Friday, April 9, 2010
Emphasis on the fact that Dr. Burns is amazing!
Typically, the second Friday of the Equine Ambulatory rotation is when you get your grades. You're called in, one at a time, and the clinicians and interns give you your evaluation. That didn't happen today. Drs. Gallatin and Schmall decided not to come in today, so our grades will be posted on "one45" (a complex system the university pays for us to use) on Monday. I'm a little bummed that we didn't get the feedback, but will check my grade Monday to see how I fared.
Two of the students on my rotation went home after we played Jeopardy (which, by the way, my team won - yay!) because there were no calls. Dr. Burns squeezed four of us into her truck to go visit an acute lameness in a 17 year old Standardbred mare. We were able to locate the abscess, and begin the draining process to make her feel better. We applied MagnaPaste and wrapped the foot, with instructions to keep her inside with stall rest for 48 hours. She should be feeling better soon!
It's now noon, and I'm done for the day - and for the weekend! I am heading to the lake with Erin and the dogs! :) :) :)
Rotation #1: COMPLETE!
Two of the students on my rotation went home after we played Jeopardy (which, by the way, my team won - yay!) because there were no calls. Dr. Burns squeezed four of us into her truck to go visit an acute lameness in a 17 year old Standardbred mare. We were able to locate the abscess, and begin the draining process to make her feel better. We applied MagnaPaste and wrapped the foot, with instructions to keep her inside with stall rest for 48 hours. She should be feeling better soon!
It's now noon, and I'm done for the day - and for the weekend! I am heading to the lake with Erin and the dogs! :) :) :)
Rotation #1: COMPLETE!
Lameness...
We had a great morning meeting with Dr. Burns yesterday. After that, we went to our respective trucks. Dr. Burns was forced to take 4 students and Dr. Jury had room for 2. Amy and I went with Dr. Jury and signed up for Dr. Burns the following day.
We ended up meeting up with Dr. Schmall to do lameness exams. We examined 5 or 6 horses, each with a decently severe problem that needed treatment. We (and by we I mean Drs. Jury and Schmall [Amy and I were lucky enough to do betadine scrubs to prep the spot for 10 min]) injected joints (both hocks and stifles) and injected the back of a horse that seems to have issues in her "hip" area. Because Dr. Schmall does a poor job of explaining things and answers the question of "what are you injecting?" with "what do you think I'm injecting?", I have no clear answer as to what was injected into the muscles of the back. I have included a picture below.
After our really long appointment at that barn, we stopped to check on a horse with insulin resistance. He was very sweet and we were only there a brief time.
We ended up meeting up with Dr. Schmall to do lameness exams. We examined 5 or 6 horses, each with a decently severe problem that needed treatment. We (and by we I mean Drs. Jury and Schmall [Amy and I were lucky enough to do betadine scrubs to prep the spot for 10 min]) injected joints (both hocks and stifles) and injected the back of a horse that seems to have issues in her "hip" area. Because Dr. Schmall does a poor job of explaining things and answers the question of "what are you injecting?" with "what do you think I'm injecting?", I have no clear answer as to what was injected into the muscles of the back. I have included a picture below.
After our really long appointment at that barn, we stopped to check on a horse with insulin resistance. He was very sweet and we were only there a brief time.
Wednesday, April 7, 2010
Dr. Burns is AMAZING!!!
If I learned one thing today it is that Dr. Burns has more knowledge than anyone I've ever met before. My favorite thing about her is that she LOVES to share this wealth of knowledge with others for the betterment of everyone. SHE IS AMAZING! Dr. Burns is probably one of the best clinical teachers I could imagine existing.
Today we examined a 32 yr old mare (with PPID ["Cushings" <-- but not really) with non-weight bearing lameness in her left front limb. She's been previously laminitic and had a series of other problems. She is essentially the poster child for "Cushings-like-syndrome" in horses. We ended up blocking her foot to isolate the lameness, but were only moderately successful in exact identification. Because there are likely other issues occurring concurrently, we gave her some pain meds, wrapped the legs, and headed to the next appointment. She will get digital rads tomorrow.
Next we vaccinated 2 horses that are incredibly lucky horses. As Sam said... if she were a horse, she would want to have this lady as the owner. I agree. The lady was reading with her mare when we arrived, and picked up that again as we were leaving. Her 20 year old gelding looked like he was about 10 at most. She fox hunts (which I found out today is not actually hunting foxes at all) with him, and he is quite fit and healthy. It was a routine stop, but the horses were beautiful and very well loved.
We saw a colic appointment in the afternoon - it was my first colic. As we were trying to identify the mare with complications, she laid down in the field and looked at her side. Perfect. There was our colic case. We brought her in, and I sedated her. We ran a nasogastic tube to check for reflux, which was absent in quantities outside of normal limits. I gave an IV injection of Banamine and we told the owner how to handle the feeding and to call if there were any problems.
One horse needing spring shots was left. We gave the vaccinations and headed back to the clinic, getting back around 5 or so. It was a really fun, educational day. I love Dr. Burns and am really happy I had the opportunity to pick her brain as long as I did today!
Today we examined a 32 yr old mare (with PPID ["Cushings" <-- but not really) with non-weight bearing lameness in her left front limb. She's been previously laminitic and had a series of other problems. She is essentially the poster child for "Cushings-like-syndrome" in horses. We ended up blocking her foot to isolate the lameness, but were only moderately successful in exact identification. Because there are likely other issues occurring concurrently, we gave her some pain meds, wrapped the legs, and headed to the next appointment. She will get digital rads tomorrow.
Next we vaccinated 2 horses that are incredibly lucky horses. As Sam said... if she were a horse, she would want to have this lady as the owner. I agree. The lady was reading with her mare when we arrived, and picked up that again as we were leaving. Her 20 year old gelding looked like he was about 10 at most. She fox hunts (which I found out today is not actually hunting foxes at all) with him, and he is quite fit and healthy. It was a routine stop, but the horses were beautiful and very well loved.
We saw a colic appointment in the afternoon - it was my first colic. As we were trying to identify the mare with complications, she laid down in the field and looked at her side. Perfect. There was our colic case. We brought her in, and I sedated her. We ran a nasogastic tube to check for reflux, which was absent in quantities outside of normal limits. I gave an IV injection of Banamine and we told the owner how to handle the feeding and to call if there were any problems.
One horse needing spring shots was left. We gave the vaccinations and headed back to the clinic, getting back around 5 or so. It was a really fun, educational day. I love Dr. Burns and am really happy I had the opportunity to pick her brain as long as I did today!
Tuesday, April 6, 2010
I almost died twice today.
I guess that's being slightly dramatic, but it's kind of true.
After a fun morning with Schmall, telling stories of a clinician he had in school who referred to the girls as "angels of mercy" (except one, who he called "angel of death") as well as many other stories that had us laughing, Amy and I decided to ride with Dr. Schmall for the day.
Our first stop was to radiograph 2 horses. The first was a 3 year old Thoroughbred (prior race horse) who was young and misbehaved. I was holding the horse when something must have spooked him. He was standing about 2 feet away from $85,000 of digital x-ray equipment when he began freaking out on me and backing up. "Get him up!" Dr. Schmall frantically yelled to me. I was trying, as best as I knew how, pulling as hard as I could to try to move the horse forward and away from the equipment. I got him a few steps when he jerked his head as high back as he could, snapping the lead rope. Suddenly we had a 1000+ lb unrestrained horse much too close to the equipment. What do you do when all you have in your hand is the torn off end of the lead rope? Dr. Schmall tapped the horse's rear end to get him to move forward, but he reared a bit in my direction. Trying not to panic, I looked to the owner of the horse who was now standing by the horse and had just yelled something along the lines of "she no longer has control of him". Nope! I sure didn't! The horse came forward towards me, I stood my ground, she grabbed a hold of him and he calmed down. I took hold of him again and we were able to get the right radiographs. Whew! My heart was racing.
Our next stop was uneventful and pretty routine. We did a few lameness exams on a variety of horses, dispensed some meds, and headed to our next stop!
Our last appointment of the day also proved to be quite interesting. We began with a pre-purchase exam (something quite common in the world of horses - a veterinarian evaluates a horse and makes note of anything they find that seems to be abnormal and reports this information to the buyer and seller). Starting with the neuro exam, Dr. Schmall drilled Amy and I on cranial nerves. Needless to say, we were a bit rusty in naming ALL of them and giving the exact tests for them. Dr. Schmall told us that it was valuable information that we should know - the first thing I did when I got home (after laying top soil and planting grass) was look up neurological exams in horses. You better believe I'm prepared to answer tomorrow if Dr. Schmall asks me again.
After that, we had to look at a few lame horses. Typically uneventful, you jog the horse down and back in order to check the gate. It was my turn to run with the horse. I was handed a "nice horse" who had been on stall rest for a few weeks. "He's really good. He'll go right with you" Dr. Schmall noted. I "clucked" (I believe that's what it's called in the horse world) and the horse did NOT come right with me. He freaked out, spun around, and moved backwards the other direction. Pulling down hard a few times, he finally stopped. Whew! "Ok, now just try it again" I was instructed. And so I did. The damn thing did it again! Of course, it never fails that there is a group of people (including the owner of the horse, the owner of the barn, riders, etc) watching you attempt to control the horse. Really? This happened to me twice in one day? Yes, really. Twice in one day. After that, I got the horse to behave, jogged him, and examined his suspensory ligament. It was quite sore.
From that horse, we moved on to another in need of joint injections. Amy and I scrubbed the heel bulbs after Dr. Schmall had given local anesthetic (which was after I had given IV sedation). He injected the joints and Amy and I wrapped the feet! To the left is a picture - I did the right foot and Amy did the left (that's her in the picture!). We injected some mares with progesterone and headed back to school for the day. It was a long enough day for me.
Whew! I survived. The $85,000 digital x-ray machine and computer survived. And, I'll do it all over again tomorrow...
After a fun morning with Schmall, telling stories of a clinician he had in school who referred to the girls as "angels of mercy" (except one, who he called "angel of death") as well as many other stories that had us laughing, Amy and I decided to ride with Dr. Schmall for the day.
Our first stop was to radiograph 2 horses. The first was a 3 year old Thoroughbred (prior race horse) who was young and misbehaved. I was holding the horse when something must have spooked him. He was standing about 2 feet away from $85,000 of digital x-ray equipment when he began freaking out on me and backing up. "Get him up!" Dr. Schmall frantically yelled to me. I was trying, as best as I knew how, pulling as hard as I could to try to move the horse forward and away from the equipment. I got him a few steps when he jerked his head as high back as he could, snapping the lead rope. Suddenly we had a 1000+ lb unrestrained horse much too close to the equipment. What do you do when all you have in your hand is the torn off end of the lead rope? Dr. Schmall tapped the horse's rear end to get him to move forward, but he reared a bit in my direction. Trying not to panic, I looked to the owner of the horse who was now standing by the horse and had just yelled something along the lines of "she no longer has control of him". Nope! I sure didn't! The horse came forward towards me, I stood my ground, she grabbed a hold of him and he calmed down. I took hold of him again and we were able to get the right radiographs. Whew! My heart was racing.
Our next stop was uneventful and pretty routine. We did a few lameness exams on a variety of horses, dispensed some meds, and headed to our next stop!
Our last appointment of the day also proved to be quite interesting. We began with a pre-purchase exam (something quite common in the world of horses - a veterinarian evaluates a horse and makes note of anything they find that seems to be abnormal and reports this information to the buyer and seller). Starting with the neuro exam, Dr. Schmall drilled Amy and I on cranial nerves. Needless to say, we were a bit rusty in naming ALL of them and giving the exact tests for them. Dr. Schmall told us that it was valuable information that we should know - the first thing I did when I got home (after laying top soil and planting grass) was look up neurological exams in horses. You better believe I'm prepared to answer tomorrow if Dr. Schmall asks me again.
After that, we had to look at a few lame horses. Typically uneventful, you jog the horse down and back in order to check the gate. It was my turn to run with the horse. I was handed a "nice horse" who had been on stall rest for a few weeks. "He's really good. He'll go right with you" Dr. Schmall noted. I "clucked" (I believe that's what it's called in the horse world) and the horse did NOT come right with me. He freaked out, spun around, and moved backwards the other direction. Pulling down hard a few times, he finally stopped. Whew! "Ok, now just try it again" I was instructed. And so I did. The damn thing did it again! Of course, it never fails that there is a group of people (including the owner of the horse, the owner of the barn, riders, etc) watching you attempt to control the horse. Really? This happened to me twice in one day? Yes, really. Twice in one day. After that, I got the horse to behave, jogged him, and examined his suspensory ligament. It was quite sore.
From that horse, we moved on to another in need of joint injections. Amy and I scrubbed the heel bulbs after Dr. Schmall had given local anesthetic (which was after I had given IV sedation). He injected the joints and Amy and I wrapped the feet! To the left is a picture - I did the right foot and Amy did the left (that's her in the picture!). We injected some mares with progesterone and headed back to school for the day. It was a long enough day for me.Whew! I survived. The $85,000 digital x-ray machine and computer survived. And, I'll do it all over again tomorrow...
Week 2, Day 1:Hoof abscess!
The day got off to a bit of a slow start. We (the students) met in the Clubhouse at 9. After realizing that no vets were going to come to the Clubhouse, we headed to the equine section of the barn. It turned out that Dr. Freeling's truck wouldn't start at her apartment so Dr. Gallatin had to go and help jump the truck. Still not starting, they had it towed. When Dr. Freeling arrived at school, Amy and I were set and ready to go with her. Sam was going to come with us too, but had a surprise ride-along with Schmall after being instructed that no one was riding with him yesterday. She was quite happy, and I was happy for her that she was able to ride with him.
We headed to our first farm. We thought maybe we would draw some blood for Coggins, but it turned out that we would just vaccinate about 6 horses. After vaccinations were complete, we did an eye exam on a paint horse that has began spooking easily. Dr. Freeling allowed both Amy and me to use the ophthalmascope to look in the eye. We were both able to see the retina, but nothing more with the head jerking. With what appeared to be normal vision, we left the farm.
Next we headed down to see a lame horse. By the time we arrived, she was 4/5 on the lameness scale in her right front. Because of the acute onset, likely differentials included abscess, sole bruising, etc. We (and by we I mean the rider of the horse) took of the shoe and assessed the problem a bit deeper. Sure enough, Dr. Freeling discovered an abscess and was able to get it to start draining! We packed and wrapped the foot, administered IV Bute, and were on our way back to school! I have included a picture, and you can see the area in black is where the abscess began to drain and the other picture is of the horse's hoof all wrapped up!
We headed to our first farm. We thought maybe we would draw some blood for Coggins, but it turned out that we would just vaccinate about 6 horses. After vaccinations were complete, we did an eye exam on a paint horse that has began spooking easily. Dr. Freeling allowed both Amy and me to use the ophthalmascope to look in the eye. We were both able to see the retina, but nothing more with the head jerking. With what appeared to be normal vision, we left the farm.
Next we headed down to see a lame horse. By the time we arrived, she was 4/5 on the lameness scale in her right front. Because of the acute onset, likely differentials included abscess, sole bruising, etc. We (and by we I mean the rider of the horse) took of the shoe and assessed the problem a bit deeper. Sure enough, Dr. Freeling discovered an abscess and was able to get it to start draining! We packed and wrapped the foot, administered IV Bute, and were on our way back to school! I have included a picture, and you can see the area in black is where the abscess began to drain and the other picture is of the horse's hoof all wrapped up!
Monday, April 5, 2010
Easter Sunday: No calls.
I realized that I forgot to write about the conclusion of my first week on Friday. It was a great week, and it went quickly. If this is any indication of how fast clinics are going to go, I will barely blink before they're finished!!
Friday we saw 2 eye ulcers in horses. The first has a superficial palpebral lavage in place, and the owners have been administering medications through this lavage system. The eye was cloudy on Friday, with corneal edema. We needed to get a better exam of the eye so we needed to do a nerve block. We got to the truck and Dr. Freeling asked me "what are you going to do, doc?" Oh, gosh... This was my first day riding solo with a vet in the truck, and all eyes were on me.... what was I going to do? "We are going to block the branch of cranial nerve 5", I told her. She asked if that was sensory or motor. Sensory, of course. I knew this - how did I know this? Somehow a wealth of knowledge hiding deep within me was coming out and I was impressing even myself! No, we don't want to block cranial nerve 5, we want to block cranial nerve 7 - the facial nerve. "And which branch?" she asked. The auriculopalpebral branch, I told her. "They teach you that, but really it's just the palpebral branch since we're only interested in blocking the eye portion". Duh. Of course. That makes perfect sense. She went on to ask me a few more anatomy and physiology questions to make sure we were on the same page. I knew this stuff! Holy cow, I knew this stuff!
We walked back into the stall and she asked where I was going to put the carbocaine, now that we had a live animal in front of us. "Oh, I'm going to do the block?" I asked. "Of course you are" Dr. Freeling told me. And, so I did it! It went well.
After that, we had one more horse to recheck. He was huge! But, quite sweet. After that I was home for the day and able to go for a 12 mile rollerblade trip with Carrie!
I was on call and stayed in Columbus for Easter, but didn't get called in...
On to week two... YAY!!
Friday we saw 2 eye ulcers in horses. The first has a superficial palpebral lavage in place, and the owners have been administering medications through this lavage system. The eye was cloudy on Friday, with corneal edema. We needed to get a better exam of the eye so we needed to do a nerve block. We got to the truck and Dr. Freeling asked me "what are you going to do, doc?" Oh, gosh... This was my first day riding solo with a vet in the truck, and all eyes were on me.... what was I going to do? "We are going to block the branch of cranial nerve 5", I told her. She asked if that was sensory or motor. Sensory, of course. I knew this - how did I know this? Somehow a wealth of knowledge hiding deep within me was coming out and I was impressing even myself! No, we don't want to block cranial nerve 5, we want to block cranial nerve 7 - the facial nerve. "And which branch?" she asked. The auriculopalpebral branch, I told her. "They teach you that, but really it's just the palpebral branch since we're only interested in blocking the eye portion". Duh. Of course. That makes perfect sense. She went on to ask me a few more anatomy and physiology questions to make sure we were on the same page. I knew this stuff! Holy cow, I knew this stuff!
We walked back into the stall and she asked where I was going to put the carbocaine, now that we had a live animal in front of us. "Oh, I'm going to do the block?" I asked. "Of course you are" Dr. Freeling told me. And, so I did it! It went well.
After that, we had one more horse to recheck. He was huge! But, quite sweet. After that I was home for the day and able to go for a 12 mile rollerblade trip with Carrie!
I was on call and stayed in Columbus for Easter, but didn't get called in...
On to week two... YAY!!
Thursday, April 1, 2010
Day 4: 78 degrees and home by 2pm!
Today was a short day.
Our first appointment was to vaccinate and draw blood from 18 horses. Some of them were a bit jumpy, but were generally pretty easy to work with.
Our second appointment was back to collect from the same stallion we collected on Tuesday... I was able to help out a little more today since I had been there Tuesday.
We came back to school, restocked the truck, and went home!
The end.
Our first appointment was to vaccinate and draw blood from 18 horses. Some of them were a bit jumpy, but were generally pretty easy to work with.
Our second appointment was back to collect from the same stallion we collected on Tuesday... I was able to help out a little more today since I had been there Tuesday.
We came back to school, restocked the truck, and went home!
The end.
Wednesday, March 31, 2010
Day 3: Elbow deep in a penile sheath
As Dr. Schmall predicted, the boys (and by boys I mean my dogs) couldn't get enough of me today when I got home. That would be due to the remnants from cleaning horse sheaths that ended up on my scrubs and undershirt (note to self: don't wear a long-sleeved shirt next time you clean horse sheaths). Luckily, it was the last stop of the day. We laughed about how gross it was, Dr. Schmall joked that I went to school for 3 1/2 years to be able to do the job, and told of a friend of his who charges $300 to clean horse sheaths (needless to say, he does about one per year and thinks that's one too many). It is, according to Dr. Schmall, the least favorite job of any equine practitioner. I didn't realize so much dirt and grime could be up there, and I definitely didn't realize I would need to stick half of my arm inside the sheath to fully clean it! Oh, and the smegma beans... they really look like beans when you pull them out of the diverticulum with your finger. I successfully cleaned two horses today!
I also sedated both of these horses - we used a combination of xylazine, butorphanol, and detomidine. By the end of the day, I was comfortable sedating horses. Earlier this morning I wasn't 100% confident that I could quickly administer IV sedation, and passed off the task to Leighanne (a "super senior") as Dr. Schmall was holding an ornery horse that doesn't like needles and instructed us "get over here, and do it fast". However, after sedated we were able to use the endoscope up the nose to get a visual of the guttural pouch, insert a tube into it, and administer meds (I actually injected the meds!). Dr. Schmall has been treating this horse for a few days for the guttural pouch infection, but there is still exudate and he will continue treatments daily until she's feeling better.
To backtrack a bit, our first stop of the morning was pretty uneventful. We just dropped off some meds for a horse with inflammatory airway disease and talked with the owners for a bit. From there, we went to a farm where a horse was experiencing lameness in the right forelimb. The radiographs showed that the shoe was bent in a manner that was likely caused by catching the heel of the shoe and forcing the center of it into the hoof. Not by coincidence the farrier was at the farm during our visit. He removed the shoe, flattened it, and replaced it on the horse's hoof. The guttural pouch was the next stop, and it was a fairly quick visit. From there, we headed to our most involved appointment of the day - the farm where I was lucky enough to clean the male horses.
We also vaccinated 15-20 horses, and drew blood for Coggins tests on most of them. I can say with confidence that I feel comfortable drawing blood from horses after today! It's very rewarding to begin to have confidence in my abilities. While it was a stressful day riding with Dr. Schmall (he even got out of the truck once and before we could get out of the truck, he had vanished into one of the surrounding barns), I learned a lot. The conversations in the truck on the way to and from farms are definitely beneficial in building my knowledge bank. I also learned today that Dr. Schmall is from Iowa, he grew up working with pigs, did research with pigs, and really likes pigs - score! Here's hoping next time around won't be quite as awkward.
On call again tonight, but still haven't been called in for an emergency...
I also sedated both of these horses - we used a combination of xylazine, butorphanol, and detomidine. By the end of the day, I was comfortable sedating horses. Earlier this morning I wasn't 100% confident that I could quickly administer IV sedation, and passed off the task to Leighanne (a "super senior") as Dr. Schmall was holding an ornery horse that doesn't like needles and instructed us "get over here, and do it fast". However, after sedated we were able to use the endoscope up the nose to get a visual of the guttural pouch, insert a tube into it, and administer meds (I actually injected the meds!). Dr. Schmall has been treating this horse for a few days for the guttural pouch infection, but there is still exudate and he will continue treatments daily until she's feeling better.
To backtrack a bit, our first stop of the morning was pretty uneventful. We just dropped off some meds for a horse with inflammatory airway disease and talked with the owners for a bit. From there, we went to a farm where a horse was experiencing lameness in the right forelimb. The radiographs showed that the shoe was bent in a manner that was likely caused by catching the heel of the shoe and forcing the center of it into the hoof. Not by coincidence the farrier was at the farm during our visit. He removed the shoe, flattened it, and replaced it on the horse's hoof. The guttural pouch was the next stop, and it was a fairly quick visit. From there, we headed to our most involved appointment of the day - the farm where I was lucky enough to clean the male horses.
We also vaccinated 15-20 horses, and drew blood for Coggins tests on most of them. I can say with confidence that I feel comfortable drawing blood from horses after today! It's very rewarding to begin to have confidence in my abilities. While it was a stressful day riding with Dr. Schmall (he even got out of the truck once and before we could get out of the truck, he had vanished into one of the surrounding barns), I learned a lot. The conversations in the truck on the way to and from farms are definitely beneficial in building my knowledge bank. I also learned today that Dr. Schmall is from Iowa, he grew up working with pigs, did research with pigs, and really likes pigs - score! Here's hoping next time around won't be quite as awkward.
On call again tonight, but still haven't been called in for an emergency...
Tuesday, March 30, 2010
Day 2: Collecting a Stallion
Today was all sorts of wonderful! For starters, I came prepared and dressed appropriately for today's ride-alongs. Yesterday it somehow didn't occur to me that I would be outside all day and scrubs and a rain coat would not protect me from the 40 degree weather. Today, my down jacket was barely needed in the shade (a welcomed change). Also, I got to ride with Dr. Jury today. I knew Kristin when she was in vet school at Ohio State, as she is a fellow Oatie (the endearing term for OTS members). She is currently doing an internship at OSU in Equine Ambulatory, and does a great job of teaching students!
Our first appointment of the day was to collect a stallion. For anyone not
involved in veterinary medicine or the breeding animal world, you may wonder what "collecting" means. It's the politically correct way of describing the process of manually collecting the semen from an animal, typically done for artificial insemination and breeding purposes. We collected in my Equine Production class in undergrad, but it has been 5 years since I last collected from a stallion. We prepared the AV (artificial vagina), brought in a teaser mare to get the stallion prepared, and Dr. Jury collected from the stallion. The picture to the left is my classmate, Sam, holding the AV. In the background you can see the stallion's "girlfriend for the day" (the dummy he mounted for collection).
From there, we went to check on a coronary band laceration that occurred sometime last week. Sam and I got a TPR (temperature, pulse, and respiratory rate) on the horse and cleaned up the wound. Dr. Jury taught the barn owner how to properly wrap the horse's leg and administer the SMZ (Sulfamethoxazole), and we were on our way to the next stop!
Our next appointment was to look at some "broken horses". A broken horse is one that is lame, typically having issues in the feet and lower limbs. Dr. Jury had Sam and me identify the lame legs and I was correct in finding the lameness both times (yay)! Sam and I also used the hoof testers to see if we could detect any apparent pain in the hooves. I treated the first horse with a sweat wrap, something that was new and fascinating to me. First, I covered the affected portion of the leg with a poultice. Next, I covered that evenly with a thin layer of plastic (in this case, a palpation sleeve cut to fit). After that, I used a sterile combine cotton wrap to wrap the leg. To hold the cotton in place, I used a layer of Vet-Wrap and finished off the top and bottom of the wrap with Elastikon to ensure no debris could enter the bandage. I have included a picture of the wrapped leg. To protect the horse's identity, I have omitted her face and name.
When we returned the hospital, Sam and I restocked the truck. After that, we examined the semen from the stallion we collected this morning. Unfortunately, we only put extender in the semen to be used for AI and didn't put any in the semen to be examined! While it was still quite interesting to see, all of the sperm were dead!
After collecting the last of our items from the pharmacy and central supply, we were able to head home to enjoy the sunshine! I made it home today in time to give both of the dogs baths and allow them to dry in the sun! I also took a brief nap outside, read some of the book Kara lent me (How Doctors Think), and read up on the nerve blocks we covered in our group session this morning. I am riding with Dr. Schmall tomorrow...
Our first appointment of the day was to collect a stallion. For anyone not
involved in veterinary medicine or the breeding animal world, you may wonder what "collecting" means. It's the politically correct way of describing the process of manually collecting the semen from an animal, typically done for artificial insemination and breeding purposes. We collected in my Equine Production class in undergrad, but it has been 5 years since I last collected from a stallion. We prepared the AV (artificial vagina), brought in a teaser mare to get the stallion prepared, and Dr. Jury collected from the stallion. The picture to the left is my classmate, Sam, holding the AV. In the background you can see the stallion's "girlfriend for the day" (the dummy he mounted for collection).From there, we went to check on a coronary band laceration that occurred sometime last week. Sam and I got a TPR (temperature, pulse, and respiratory rate) on the horse and cleaned up the wound. Dr. Jury taught the barn owner how to properly wrap the horse's leg and administer the SMZ (Sulfamethoxazole), and we were on our way to the next stop!
Our next appointment was to look at some "broken horses". A broken horse is one that is lame, typically having issues in the feet and lower limbs. Dr. Jury had Sam and me identify the lame legs and I was correct in finding the lameness both times (yay)! Sam and I also used the hoof testers to see if we could detect any apparent pain in the hooves. I treated the first horse with a sweat wrap, something that was new and fascinating to me. First, I covered the affected portion of the leg with a poultice. Next, I covered that evenly with a thin layer of plastic (in this case, a palpation sleeve cut to fit). After that, I used a sterile combine cotton wrap to wrap the leg. To hold the cotton in place, I used a layer of Vet-Wrap and finished off the top and bottom of the wrap with Elastikon to ensure no debris could enter the bandage. I have included a picture of the wrapped leg. To protect the horse's identity, I have omitted her face and name.When we returned the hospital, Sam and I restocked the truck. After that, we examined the semen from the stallion we collected this morning. Unfortunately, we only put extender in the semen to be used for AI and didn't put any in the semen to be examined! While it was still quite interesting to see, all of the sperm were dead!
After collecting the last of our items from the pharmacy and central supply, we were able to head home to enjoy the sunshine! I made it home today in time to give both of the dogs baths and allow them to dry in the sun! I also took a brief nap outside, read some of the book Kara lent me (How Doctors Think), and read up on the nerve blocks we covered in our group session this morning. I am riding with Dr. Schmall tomorrow...
Monday, March 29, 2010
day 1: horses have four legs, one head, and one tail
Today was the first day of clinics, and I began my clinical rotations on Equine Ambulatory. I must begin reflecting on today by giving a special thanks to Erin & Megan for helping to prepare me for clinics. We started at 9am this morning. When I arrived at school, my first priority was to find Megan. She showed me where I would need to go - "The Clubhouse". I was glad she did, as my 4 classmates on the rotation with me walked in together after wandering around the hospital. I wish I had known sooner that they didn't know where to go, I would have shown them the room that Megan showed me! Needless to say, we all made it there before Dr. Schmall and that was really all that mattered.
Dr. Schmall, an older equine practitioner with the intensity of a lion stalking its prey, introduced us to the rotation. We were to sign up to ride with various vets as well as emergency shifts. The sheet was passed from one person to the next, and hesitantly the slots were filled by new senior vet students not knowing what to expect.
Two of my classmates picked their fate and rode with Dr. Schmall on day one. I was relieved; I wouldn't be with him on the very first day. Looking at the vets available I chose to ride with Dr. Gallatin. I had her a few weeks ago in my 5 day LAOP equine crash course, and I felt that she would be a good fit for my first day of clinics.
We soon learned that Dr. Burns is only around on Fridays, which left Melissa with no one to ride with. She decided to also ride with Dr. Gallatin. We then learned that Drs. Freeley and Gallatin would be going out to appointments together, which meant that Lynn, Melissa, and I would be riding together. I asked them if it was alright that I sit in the middle of the back seat of the truck - the last thing I needed on my first day of clinics was to get carsick!
Dr. Freeley provided us with bottles of vaccine, and we quickly drew them up. She mentioned that she would go get us some Sharpies so we could label the syringes, but thanks to Megan and Erin I had multiple Sharpies with me. Starting the day with a clinician telling me that she was impressed that I was so prepared certainly made me feel good!
By 10:30 I was ordering from the pharmacy, and realizing that it was quite painless. I was catching on, and I was excited! As soon as we had everything we needed for the day, we were off! As rumored, our first stop was Dr. Gallatin's addiction - Tim Horton's. Our first appointment was an 18 day pregnancy check on a mare. She was pregnant, as detected with the ultrasound, and we packed up to head to the next appointment. Our next appointment was to administer spring shots and check a lump a couple of horses. We walked through a lot of mud to get to his horses, and I was glad I chose to go with my boots and not my Danskos when selecting my shoes for the day. We arrived at the barn, and Lynn, Melissa, and I were responsible for giving the vaccines! Dr. Gallatin says that her goal is to not have to touch the horses, meaning we get to do most of the work!
After vaccinating the horses (and learning the 5 standard horse vaccines), we were on our way to recheck an eye ulcer. The best part about this next stop was the adorable puppy running around the barn. He did, however, eat an entire dead mouse while we were there so we stopped accepting his puppy kisses. The owner of the horse declined going in for surgery due to cost and Drs. Gallatin and Freeley decided to change the treatment in hopes that the eye might begin to heal. When we got back in the truck, they let us know that the eye will most likely need to be removed.
From there, we headed out to vaccinate 22 horses allowing us the opportunity to become completely proficient in administering horse vaccines. The "R" vaccines go on the right, and the others go on the left. "R" vaccines include rabies (sometimes in combination with Potomac Horse Fever) and Rhino/Flu vaccine. The additional vaccine was a 4-way vaccine containing WEE, EEE, WNV, and tetanus.
Next stop included drawing blood for a Coggins test (to check for Equine Infectious Anemia) as well as placement of a Foalert. This is a device containing a magnet that is sutured onto the vulva to detect foaling on farms that don't have someone watching the mares. The placement made me (and Lynn) cringe. The transmitter activates a receiver which sends a radio signal and an alert to the owners once the device is separated (presumably by the foal's feet as they emerge at birth).
Our last stop of the day was a horse needing spring shots as well as one needing health papers. We headed back to the clinic, and arrived shortly before 5. Upon arrival, we restocked the truck and headed home.
I'm on call tonight, but haven't yet been called in. This morning I felt like I knew very little about horses. While that might still be true, I feel more comfortable after only one day! Tomorrow we start at 8am with an hour lecture - luckily, I have already reviewed Meggy's notes from last year and feel pretty good about what we'll cover!
Dr. Schmall, an older equine practitioner with the intensity of a lion stalking its prey, introduced us to the rotation. We were to sign up to ride with various vets as well as emergency shifts. The sheet was passed from one person to the next, and hesitantly the slots were filled by new senior vet students not knowing what to expect.
Two of my classmates picked their fate and rode with Dr. Schmall on day one. I was relieved; I wouldn't be with him on the very first day. Looking at the vets available I chose to ride with Dr. Gallatin. I had her a few weeks ago in my 5 day LAOP equine crash course, and I felt that she would be a good fit for my first day of clinics.
We soon learned that Dr. Burns is only around on Fridays, which left Melissa with no one to ride with. She decided to also ride with Dr. Gallatin. We then learned that Drs. Freeley and Gallatin would be going out to appointments together, which meant that Lynn, Melissa, and I would be riding together. I asked them if it was alright that I sit in the middle of the back seat of the truck - the last thing I needed on my first day of clinics was to get carsick!
Dr. Freeley provided us with bottles of vaccine, and we quickly drew them up. She mentioned that she would go get us some Sharpies so we could label the syringes, but thanks to Megan and Erin I had multiple Sharpies with me. Starting the day with a clinician telling me that she was impressed that I was so prepared certainly made me feel good!
By 10:30 I was ordering from the pharmacy, and realizing that it was quite painless. I was catching on, and I was excited! As soon as we had everything we needed for the day, we were off! As rumored, our first stop was Dr. Gallatin's addiction - Tim Horton's. Our first appointment was an 18 day pregnancy check on a mare. She was pregnant, as detected with the ultrasound, and we packed up to head to the next appointment. Our next appointment was to administer spring shots and check a lump a couple of horses. We walked through a lot of mud to get to his horses, and I was glad I chose to go with my boots and not my Danskos when selecting my shoes for the day. We arrived at the barn, and Lynn, Melissa, and I were responsible for giving the vaccines! Dr. Gallatin says that her goal is to not have to touch the horses, meaning we get to do most of the work!
After vaccinating the horses (and learning the 5 standard horse vaccines), we were on our way to recheck an eye ulcer. The best part about this next stop was the adorable puppy running around the barn. He did, however, eat an entire dead mouse while we were there so we stopped accepting his puppy kisses. The owner of the horse declined going in for surgery due to cost and Drs. Gallatin and Freeley decided to change the treatment in hopes that the eye might begin to heal. When we got back in the truck, they let us know that the eye will most likely need to be removed.
From there, we headed out to vaccinate 22 horses allowing us the opportunity to become completely proficient in administering horse vaccines. The "R" vaccines go on the right, and the others go on the left. "R" vaccines include rabies (sometimes in combination with Potomac Horse Fever) and Rhino/Flu vaccine. The additional vaccine was a 4-way vaccine containing WEE, EEE, WNV, and tetanus.
Next stop included drawing blood for a Coggins test (to check for Equine Infectious Anemia) as well as placement of a Foalert. This is a device containing a magnet that is sutured onto the vulva to detect foaling on farms that don't have someone watching the mares. The placement made me (and Lynn) cringe. The transmitter activates a receiver which sends a radio signal and an alert to the owners once the device is separated (presumably by the foal's feet as they emerge at birth).
Our last stop of the day was a horse needing spring shots as well as one needing health papers. We headed back to the clinic, and arrived shortly before 5. Upon arrival, we restocked the truck and headed home.
I'm on call tonight, but haven't yet been called in. This morning I felt like I knew very little about horses. While that might still be true, I feel more comfortable after only one day! Tomorrow we start at 8am with an hour lecture - luckily, I have already reviewed Meggy's notes from last year and feel pretty good about what we'll cover!
Sunday, March 28, 2010
and so it begins...
Well, it's real. It's really happening. Tomorrow morning is the first day of my senior clinical rotation of veterinary school. I've received my white coat, and I'm officially a fourth year veterinary student. Me. Jamie Berning. Senior Veterinary Student.
I'm currently filled with an array emotions flooding my body and mind. I'm more excited than I could have imagined; I've done it! I'm here! Finally. I'm more nervous than I could have imagined; Am I ready for this? How am I possibly going to remember everything I learned over the past 3 years in class? I'm more terrified than I could have imagined; How will I react the first time I have a patient die? What will I do when they ask me to perform a skill I simply can't remember or have never performed? I'm more relieved than could have imagined; I really don't have to sit through lectures everyday? Am I honestly finished taking midterms and final exams?
As these emotions stir within me, I think back to everything I have done to get to where I am. My mom proudly tells the story of the declaration I made when I was just 5 years old "When I grow up, I want to be a veterinarian" she'll quote. She continues to add "and you always told me you would go to Ohio State". Thank you, mom, for supporting me endlessly over the past twenty-six years of my life. For the hours of studying, quizzing me on words you could barely pronounce, and encouragement you provided when I didn't think I could do it anymore I will forever be grateful. I truly could not have done this without the support of my family and amazing friends.
I was recently looking through my 7th grade yearbook. I was voted most likely to be a veterinarian. Then I flipped through my 8th grade yearbook. I was, again, voted most likely to be a veterinarian. I found my senior scrapbook from high school. Under my plans for the future, I wrote about attending OSU and becoming a veterinarian. When I got to college, they (advisors and administrators) told us (the pre-vet students) that less than half of us would go to vet school. I thought they were trying to scare us, that there was simply no truth to their statement. Of the group of four who vowed to go to vet school together as college freshmen in 2001, two of us did it. They were right - only the truly dedicated would make it.
It would be impossible to count the hours I spent studying to get to where I am. It would be equally as impossible to count the hours I spent crying, worrying, and doubting myself. I believe it is my persistence that has brought me this far. I wouldn't, I couldn't, let go of my dream. Even when I felt like I couldn't make it, when I was swamped with twenty-nine credit hours and my life revolved around classes in vet school, I pushed through.
They assured us yesterday at our White Coat Ceremony that we are ready for this. They told us that there will be times when we won't know the answers, we won't know the diagnosis, and we won't even know where to start. I know they're right. I've spent the past few weeks flipping through my equine anatomy books, reading through past lectures (yes, even those horrid orthopedic lectures I swore didn't matter to me because I would never work with horses or their legs), and attempting to memorize all of the common conditions, normal values, and vaccine protocols in my Pasquini "Guide to Equine Clinics" book. I still feel like I won't know where to start.
It's here. Tomorrow I will lay my hands on a live patient. It will be my patient. And I will be the senior veterinary student working with the clients. I am ready to begin this very new, very exciting, and very terrifying adventure in my life. As I scramble to learn as much as I can about horses tonight, I can't forget why I'm doing this. It all started one day when I was five years old and I told my mom "When I grow up, I want to be a veterinarian".
I'm currently filled with an array emotions flooding my body and mind. I'm more excited than I could have imagined; I've done it! I'm here! Finally. I'm more nervous than I could have imagined; Am I ready for this? How am I possibly going to remember everything I learned over the past 3 years in class? I'm more terrified than I could have imagined; How will I react the first time I have a patient die? What will I do when they ask me to perform a skill I simply can't remember or have never performed? I'm more relieved than could have imagined; I really don't have to sit through lectures everyday? Am I honestly finished taking midterms and final exams?
As these emotions stir within me, I think back to everything I have done to get to where I am. My mom proudly tells the story of the declaration I made when I was just 5 years old "When I grow up, I want to be a veterinarian" she'll quote. She continues to add "and you always told me you would go to Ohio State". Thank you, mom, for supporting me endlessly over the past twenty-six years of my life. For the hours of studying, quizzing me on words you could barely pronounce, and encouragement you provided when I didn't think I could do it anymore I will forever be grateful. I truly could not have done this without the support of my family and amazing friends.
I was recently looking through my 7th grade yearbook. I was voted most likely to be a veterinarian. Then I flipped through my 8th grade yearbook. I was, again, voted most likely to be a veterinarian. I found my senior scrapbook from high school. Under my plans for the future, I wrote about attending OSU and becoming a veterinarian. When I got to college, they (advisors and administrators) told us (the pre-vet students) that less than half of us would go to vet school. I thought they were trying to scare us, that there was simply no truth to their statement. Of the group of four who vowed to go to vet school together as college freshmen in 2001, two of us did it. They were right - only the truly dedicated would make it.
It would be impossible to count the hours I spent studying to get to where I am. It would be equally as impossible to count the hours I spent crying, worrying, and doubting myself. I believe it is my persistence that has brought me this far. I wouldn't, I couldn't, let go of my dream. Even when I felt like I couldn't make it, when I was swamped with twenty-nine credit hours and my life revolved around classes in vet school, I pushed through.
They assured us yesterday at our White Coat Ceremony that we are ready for this. They told us that there will be times when we won't know the answers, we won't know the diagnosis, and we won't even know where to start. I know they're right. I've spent the past few weeks flipping through my equine anatomy books, reading through past lectures (yes, even those horrid orthopedic lectures I swore didn't matter to me because I would never work with horses or their legs), and attempting to memorize all of the common conditions, normal values, and vaccine protocols in my Pasquini "Guide to Equine Clinics" book. I still feel like I won't know where to start.
It's here. Tomorrow I will lay my hands on a live patient. It will be my patient. And I will be the senior veterinary student working with the clients. I am ready to begin this very new, very exciting, and very terrifying adventure in my life. As I scramble to learn as much as I can about horses tonight, I can't forget why I'm doing this. It all started one day when I was five years old and I told my mom "When I grow up, I want to be a veterinarian".
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