And so it starts...

I was up at 6, partly because I actually got enough sleep over the weekend (yay naps) and partly because of first day of school jitters. I was showered and out of the house fed and coffee'd and everything by 7:15, and made it to school by 7:30 by bike.

I did my locker stuff, checked my mail and hung out and finished my coffee until about 7:50, then headed over to Ophtho for orientation. The other three people on my rotation showed up right at 8am, I felt weird standing around being early for 10 minutes. I'm NEVER the early one!

Orientation was actually fun. Dr P is really an amazing teacher, particularly when it was just her and 4 of us. We went over all of the intake and exam stuff, and actually got to do it all on a volunteer dog (J, one of the ophtho tech's dog). J hung out all day, which was neat except for the bits where he was dog aggressive to some of our patients... oops. After 2 hours of going through stuff, which I swear flew by, I kinda felt like maybe I had a grasp on what I was supposed to be doing and in what order. Then appointments started!

I sat in on part of a "blind dog" exam that was P's case. The dog has a number of neurological changes in the last month, including loss of vision. We did an electroretinograph (ERG) at lunchtime, and the retina was mostly processing light normally. That confirmed the neurologist's diagnosis of a brain tumor inducing cortical blindness, which kinda sucked.

I went in with J on a dog who was a recheck for a lens luxation. The lens was hanging out in the back of the eye, and the dog has been on drops for years that cause the irises to seriously be pinpricks. I've heard the memory tool of: parasympathomimetics produce pinpoint pupils - but I'd never actually had the opportunity to see just how SMALL it makes them. I'd say the pupil was less than a millimeter in diameter, when a normal dog - even in very bright light - can usually only get down to 3 or 4mm. The other lens on the dog was "loose" and was also be kept in check with the drops. The theory is that a lens that's not where it's supposed to be but in the posterior chamber of the eye does a lot less damage and causes a lot fewer side effects than a lens hanging out in the anterior chamber (against the cornea). The dog passed the recheck with flying colors.

My first "primary" case of the day was a dog who had "possible glaucoma" from the referring vet (rDVM). The little shih tzu was adorable, but her eyes were AWFUL. In her left eye she had blood vessels growing across the cornea and increased corneal thickness from chronic inflammation and irritation probably from dry eye (keratoconjunctavitis sicca, KCS). The dog also had both nuclear sclerosis and a small cataract in the eye. She had about 25% vision in the left eye, and was mostly likely only seeing shapes and shadows. Her right eye was worse.

The right eye was completely blind, had both neovascularization (the corneal blood vessels), pigmentation from chronic irritation, clinical dry eye (KCS) diagnosed by a tear production test, and a small ulcer. The parts of the cornea that we could see through showed that the eye itself was filled with blood, called hyphema. The intraocular pressure of the eye was also between 24 and 34, diagnostic for glaucoma (increased pressure inside the eye). We (okay, Dr K) suspected a mass inside the eye, retinal detachment from high blood pressure, or a clotting disorder. The owners declined an ultrasound (to look for a mass or a blood clot or retinal detachment) and bloodwork, and opted to only treat the ulcer and the glaucoma. The treatment for the dry eye is another set of drops given 2-3 times daily, and they were having trouble considering that many eyedrops per day. the treatment for the blood in the eye is steroids, and we can't give steroids into the eye while there's an ulcer present.

In the end, we still ended up sending the dog home on three separate eye drops, which have to be given 5 minutes apart 3 times a day, and kept the dog on oral steroids that the rDVM had prescribed. It was a very hard case to write up, just because there were so many findings that may or may not be related, dependent on the workup we were not allowed to do, and then the instructions for the medications were challenging as well.

And that was just before lunch!

After lunch I, um, oh crap. I forget already. I know that I did an emergency that came in with a fixed, dilated pupil. It was this cute little 5ish year old miniature poodle who weighed all of 5 pounds. She could see fine, wasn't painful, squinted a little - but mostly had been into the vet this morning and the rDVM had noticed the eye abnormality and referred her in. I did everything right, got good readings, and the dog ended up being diagnosed with profound iris atrophy. That essentially means that for some animals the iris just... goes away. It doesn't affect the dog's vision, but they can become sensitive to very bright lights... predictably. We noticed that the other eye had the beginnings of atrophy as well, and advised the owner to check out www.doggles.com - but that was about as far as we had to go. It was a great learning experience as well as a fun time.

I appear to have lost a couple of hours in the afternoon - I wonder what I was doing during that time... But that was just the first day!

Tomorrow, entropion surgery and teaching sophomores eye exams!

Type A personalities

Rotations start tomorrow. Orientation was overwhelming, but was an incredible amount of useful information. I NEARLY feel prepared to start tomorrow!!

I spent much of yesterday reviewing my ophtho notes - today holds much of the same for me. I'm REALLY excited though.

And, we (me, helen, carrie) found the perfect 6-holed tiny binders for rotations. Along with folders, calculators, refills of paper ....

Office supply stores are DANGEROUS for type A personalities!

No more teachers, no more books...

Today was the last day of classes!! It's been so long coming, yet it seems kind of surreal. We don't start clinics for another two weeks though. Next week is a course on law, ethics and practice management - technically still a class, but an 8-5 pass/fail kinda class. Trust me, it doesn't count. Same prof, same expectations, same classroom - it's not the same as having 2 hour blocks of class. Then is a week of orientation - which is "technically" our first rotation. Dr Novo is the rotation coordinator, so if he's in his usual hilarity, it's going to be kind of awesome.

This weekend is our White Coat Ceremony, where we are individually presented with white coats to signify leaving the classroom and entering clinics. My mom, dad and nana will land in about 10 minutes so that they can be here for the ceremony :) My boy is obviously coming too.

Tonight is the annual "spring pig roast". However, whoever arranged it this year did a crappy job. While the theme is Luau, and prizes will be awarded for best costume, they have failed to roast a pig. Which seems like a giant waste of a party dedicated to roasting a pig to me. Also, the powers that be have told us that it has to be alcohol free. I'm going to have to find another excuse to get drunk this weekend - think I can find one? Anyways, back to the food. They're ordering catered Italian food. Did I mention it was a little ridiculous. Italian food. At a Luau. ::sigh::

EEEEEEEEEEEEEEEEEEEEEEE!!!!!!!!! NO MORE EXAMS!!!!!!!!!!!!!!!!!!

Less than a month to go!

I had this great illusion in my head when I opened the blogger dashboard that I was going to be updating in less than a month from the last time! Then I saw that I last updated just three days short of a month ago, and realized it probably doesn't count.

We are getting so close to rotations it's ridiculous. I've really adored my classes this semester - I've been learning a lot and getting to feel a lot more like I'm ready for clinics. Last week in Critical Care we had a lab where we had 3 minutes to "deal" with each case. I got less than half of them right, but nothing (when explained) was foreign to me, or didn't make sense. Baby steps. I'm glad we have guiding clinicians with us on clinics! Also, my Emergency rotation isn't until the week that I graduate, so I have some time.

We finished Orthopedics, Nutrition, Ultrasound and Public Health. Other ones too, but I can't remember them. We're really down to just Cardiology, Critical Care (and International diseases and law/ethics/regulatory stuff).

Schedule: this week - SPRING BREAK (Pennsylvania here I come!). next week - last Cardiology and CC classes, also International Diseases only class meeting. March 25 - White Coat Ceremony! The week after that - law/ethics/regulatory stuff 8-5 every day ew. THEN ORIENTATION TO CLINICS!

Well, it feels to me like it's coming up ridiculously fast, but written out it looks a lot more reasonable and like a month away. Baby steps. We start clinics on April 9.

I'm actually kind of on top of my MPH thesis at the moment. My spring break goals are to mostly have a massive rough draft. I'm hoping to defend in May, which seems forever away right now, but will attack me sooner than I expect.

Yay for a predicted 50 degrees this morning. Boo for daylight saving time making my reasonable 745am wakeup time into a slightly slacker 845 wakeup time.

This post is degenerating, so I'm gonna call it good. And hope to update sooner rather than later.

Poke me with a stick

I've been poked. Apparently I don't post often enough. It's probably true, this blog really gives very little indication of what it's like to be in vet school. Unless you can surmise that my lack of updating means that I have a lot to do, and I don't spend my time on blogger. To be honest, I spend my time on livejournal ;-) my first and true love. :-)

This semester is kinda awesome. We have 3 week long classes that meet between 5 and 10 times. They're just long enough to get into and get a handle on, and then they end before I get bored or frustrated or overwhelmed. Most of our classes have been incredibly focused on cases, which has been amazing for sorting the masses of information in my brain. The file cabinets in my brain are getting better labeled and better organized. Information and the answers to questions is coming to the tip of my tongue faster and more easily.

I'm getting more and more excited about the fact that rotations start in April. January flew by, and it's already Valentine's Day! We're 5 weeks into a semester that's only 11 weeks long. I start rotations with Ophthalmology and Necropsy - I think they'll be good for solidifying my understanding of the hospital procedures and computer systems, and then pounding some good old pathophys into my skull. I don't expect either to be a walk in the park, but I'd rather ease in with fewer all-nighters and not have to hit the ground running.

Maybe I'll try to post again soon. Maybe I should give up on this fruitless endeavor. What will happen? Only time can tell!

I suggest wine

We had our first exam of the semester last week. I really like toxicology, and the exams are straight out of the notes/book (it helps that Dr. Murphy wrote the book). I'm so far loving the increased number of take-homes and assignments this semester over just having an exam in every single class. We have our first metabolic exam on Tuesday - but it's about 80% take-home and only 5 lectures are actually on the exam. This makes me happy and very stress-free.

I broke down and bought a large animal internal medicine book last week. I was working on a take-home and realized that I actually didn't know enough about anything large animal off the top of my head. I'm excited that the book I ended up getting (which is in the other room or I'd link it) is in outline format and pretty much can be used as a study aid for my large animal GI and multisystemic classes as well. Now that's a good book! And it was relatively inexpensive (~$50), considering it's use (and how that's how I'm planning to pass boards!).

I highly suggest wine as part of a happy and healthy junior year :-)

Why I'm tracking Small Animal

Yesterday during large animal gastrology lab:

- I put an alfalfa bolus down the throat of a cow
- I put a speculum down the throat of a cow
- I inserted a (more different kind of ) speculum into a cow's mouth
- I heard the bubbles in a cow's rumen while someone else blew into a properly placed esophageal tube
- I learned how to put a speculum into a horse's mouth
- I floated a horse's teeth
- I put a nasogastric tube in a horse.

I'm really glad I had the opportunity to do these things. But overall, this is EXACTLY why I'm tracking small animal.

Where did the summer go?

Where did the summer go, anyways? I swear it was just May... Anyways, someone's been bugging me about not posting all summer, so maybe I'll do a quick summary for y'all.

I did Summer Scholars, a program where I received a stipend to work with a professor on a research project. I chose to look at MRSA (methicillan-resistant staph aureus) in animals that live in a nursing home in Saint Paul. I'm only 8 weeks into a 10 week project right now, and this week is going awfully quickly... I think I have some serious work to do tomorrow (Friday, eep!). As part of summer scholars I got to go to a symposium in Baton Rouge, LA in August. The LSU vet school is absolutely gorgeous and pretty nifty. Our rehab room is better though :-) (Their equine ICU is absolutely amazing.)

School started this week. I'm excited about the semester, and I fell back into school like no time had passed. I'm still working on getting really "organized". My goal is to be prepared by Monday for anything they can throw at me. This involves an intricate plan of what comes home to study and what stays at school so that when they change classes at the last second I still have the notes that I need. Also, I've been biking to and from school, so I'm trying to cut down on how much stuff I haul back and forth.

We sign up for senior year rotations soon, eek! Supposedly it was supposed to be today, but the system won't let us yet, so maybe tomorrow? I think I've got things just about hashed out. I've got 4 externships planned right now: 2 weeks at the Minnesota Department of Health with Dr. Joni Scheftel, 2 weeks at the Golden Valley Humane Society spaying and neutering dogs and cats, 4 weeks in Amherst, probably splitting my time between the Amherst Animal Hospital (where I started working when I was 15 1/2!) and Dr. Margaret's new hospital in Nashua. I also have a 2 week block planned at the end of January for going to prospective employers and doing a week or so with them to make sure that I could work there for at least a year after graduation. I have a couple of vacations planned: 2 weeks in Nova Scotia, 2 weeks dedicated to playing with Seabass (my best friend) and 2 weeks around Christmas to see my family.

Two of my friends are getting married next year! Fortunately, they've carefully planned their weddings "in between" rotations (the last 2 days of rotations). I know that the boy can't make it to one of them due to a business trip, but hopefully we'll both be able to make it back to Vermont for the second one.

I've almost nearly got the rotations themselves worked out. I still have to make some pretty rough decisions (oncology vs s.a. theriogenology, and the like), but I know that I'm going to like whatever schedule I end up with! I'm actually kinda glad that I don't have to decide when each rotation is myself, because I'm going to learn different things on each rotation depending on the experience and expectations with which I enter it - and I don't think I have enough information right now to actually plan the "perfect" schedule myself.

New favorite things: Google Talk's ability to make your away message whatever your music player (iTunes!) is currently playing. Google notebook (which I can't find a link to) is awesome too!

Surgery three

I was the primary surgeon this past week. Our patient was a 6 month old male Australian Shepard crossed with a black lab. This gave the effect of a black lab puppy on the small side for his age, and with a disproportionally small head. He was ridiculously cute. Two of his littermates, one male and one female, accompanied him to be sterilized by us tentative second year vet students.

It was kinda nice to be the surgeon, much less stress than doing anesthesia, and much less need to be a jack of all trades that came with being the assistant. I could concentrate on what I needed to do, and help out as I saw necessary the rest of the time. I was a tiny bit disappointed and a tiny bit relieved when we found out that he was male. I really wanted to do a spay, but at the same time most of the skills necessary are used in both surgeries, and a neuter is faster and simpler.

I had a little difficulty getting the testicles up to my incision, a pre-scrotal approach. This has to do with the fact that they were the size of marbles and the ligament had to be partly broken down before they could be externalized because it was so short. Once I got them out I was relieved that everything looked so familiar. I knew all the anatomy and could see exactly what I wanted to do for each of my sutures. I placed two modified transfixation sutures in two crush marks made by hemostats, and tied them tight. Because things were going so well, I went ahead and did both testicles before calling over a surgeon to check my stumps. I placed two lines of sutures, one subcutaneously with a simple continuous suture, the other cutaneously with three interrupted cruciates and one simple interrupted sutures. The total incision was about 2cm long.

The entire procedure took just over an hour. I left stressing over anesthesia to my trusty anesthesiologist, and I was confident enough in my technique that I wasn't constantly checking the sutures. He got a little swollen and inflamed by the end of the week, but he wasn't messing at them, and the swelling should decrease with time.

The most entertaining quirk that all three of the siblings had was their extreme reluctance to walk, both on a leash and on asphalt. Our dog was very food motivated, so by the second day we were being pretty successful at walking him with constant treats and praise as reinforcements. I think the other groups spent a lot of time right by the door or carrying their dogs.

Oh, and his name was Fabio. We renamed him "Tag" within the first couple of minutes of having met him. He was just lacking the long curly locks that would have made the name even partly appropriate.

No more surgeries until next semester. Hope their fun! Our group will certainly be staying together, as we've been having a lot of fun and being very successful.

finals week

Finals are "over". I lived. Looking back, it's almost hard to understand why I've been so stressed for the last week. But there's an exhaustion that comes with having exam after exam after exam that is hard to shake.

Left in the semester: 2 surgery exams (lecture and lab), and surgery number 3! Also a week of Avian Core and another of Integrative medicine (and elective). I'm actually pretty excited about all of it.

I'm very glad that I've "learned" to study this year. I've found a method that consistently works and has gotten me grades that I'm thoroughally satisfied with. It's been a slow process to commit information to memory that is so different than I'm used to learning, but it's getting there.

I'm hoping that I'll be able to sort it out and file it this summer, hopefully increasing it's accessibility in future semesters!