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...
Wednesday, March 31, 2010
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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