Clinics has been an amazing experience to be honest. I've loved just about every moment so far. Every case that I've had to work through has brought to light and solidified so many of the things that I sat in class learning and understanding. I'm working with live patients that have involved and loving owners attached to them. I've gotten a great handle on how to work with the owners, relay to my clinicians what the presenting complaint and physical exam findings are, and figure out what the next steps should be.
Clinics is empowering and defeating all at the same time. Just embrace it. You are a sponge in clinics. You are in clinics to just absorb all the things that you can. Embrace it!
You are going to have moments where you feel like you are on cloud nine. You really understand what is going on with your case and you can communicate the next steps and diagnostics with your clinician and rotation mates. You feel comfortable with everything that is going on surrounding your case and feel confident in how you are interacting with your clinicians.
Then there's the opposite of course! You aren't totally comfortable with the subject of your rotation. You aren't a whiz at the problems that your case is presenting with. You aren't confident in sharing your findings and thoughts with your clinicians/rotation mates. You just feel at a loss!
I don't think either of these feelings are foreign to anyone that goes through clinics. Someone may be stronger in one subject and you may be stronger than others in another subject. And I'm here to tell you that that is COMPLETELY okay.
You are a sponge and your job is to just absorb all the things that you can from clinics! Embrace the moments that you feel empowered and knowledgeable. Share your knowledge with those that may be struggling in your rotation. Embrace the moments that you feel less comfortable with your cases and reach out to those around you to seek out the answers and information. Be the sponge!
Clinics will build you up and tear you down at the same time...and that's okay! The best advice I can give to you is...just keep swimming. And of course be a sponge :)
Thursday, August 28, 2014
Sunday, July 13, 2014
The End of 7th Semester and the Start of My Clinical Year!
Since my last post a LOT has happened! (yes, Cassidy...I know I'm a slacker!)
7th semester was by far one of my most successful semesters academically. I kind of struggled in therio but pulled it together in the end :D Large Animal Surgery was actually one of my favorite courses and I did really well on my exams. By far my favorite part of the semester was the hands on procedures with both small animals and large animals. I loved loved loved doing surgical procedures.
It was sad to say good-bye to the many students and professors that I had really grown close to but good news is the veterinary profession is one small world and I'll definitely be running into them in the future.
By far the hardest good-bye I said was to RUSVM's Josh Project. I had taken a backseat in all the action as a co-chair but I was fortunate to complete one last project after the completion of the "Under the Sea" mural painting at the pediatric ward.
Hopefully this last project I completed will benefit the organization for a long time. I had always wanted to create a video that would not only promote all that Josh Project does but also educate those that see it about what Josh Project is. I hoped to include interviews from children and parents that have been impacted by the efforts of Josh Project, members of Josh Project that were enthusiastic about the role they play, the founder of Josh and Friends to share his hopes and motivation to start the organization, and for community members to share their insight on the impact that Josh Project has had. Fortunately, I was able to make this happen thanks to the collaborative efforts of Brian Spugnardi (photographer) and Laura Byers (current Josh Project chair). I lined up our interviews and before I knew it we were done with interviews and it was time to let Brian do his thing and put together a video that would capture the essence of Josh Project.
The final product turned out to be the most beautiful video compilation I could ever ask for. The interviews that contributed to this amazing message were:
Christian Nathanial - A Josh Kit recipient from one of our hospital donation visits. Christian shares a very personal take on how Josh has impacted his life and become a furever friend. It was extremely special to meet Christian and have him really articulate the impact Josh has had in his life and the meaning of the friendship he has with Josh. Christian continues to reach out to his peers who may be going through their own difficult experiences and allowing his Josh to lift up their spirits.
Kamoy and G'Neika Liburd - Mother and daughter duo. G'Neika was in the states undergoing surgery and chemotherapy for a brain tumor when she had a special delivery Josh Kit sent to her. Josh has helped her with all of her stateside trips and treatments. My interview with G'Neika was the first time I got to meet G'Neika and Kamoy in person. We had been in contact over facebook since I first learned about G'Neika. I felt like I was there with her and her mom every step of the way. When I finally met G'Neika and her mom, their love for each other really came into focus. The love between them was tangible. G'Neika is such a beautiful and strong little girl inside and out.
Toni Frederick - I was first put in touch with Toni when I went on WINNFM (a local radio station in St. Kitts) for a radio program that RUSVM does every so often with them called Animal Answers. Our program theme focused on the human-animal bond and I got to discuss how we utilize this concept with our Josh Kits for the children in the hospital. Since that interview, Toni has always been a huge fan and supporter of Josh Project. She has also been a huge personal support to me as I journeyed through the semesters at RUSVM. It was very special to be able to incorporate her insight into this video because I knew she had a good take on it from a community member perspective.
Dr. Randy Lange - I was able to meet Dr. Lange and Josh (Junior) the Golden Retriever for the first time when I accepted the 1st place Josh Challenge award on behalf of RUSVM's Josh Project at the 2013 LSU SCAVMA Symposium. Dr. Lange is the founder of Josh and Friends (the parent organization to all the Josh Project chapters at participating veterinary schools). It was important to me to incorporate him into our video in order to really bring to life the original mission of the organization. His message is incredibly special. Dr. Lange has been a huge supporter since I first contacted him when I took on the chair position at RUSVM and he continues to be a tremendous supporter in my life even now that I am in clinics.
Laura Byers - I picked Laura to be the chair in my place as I moved on into some more challenging semesters at RUSVM (6th and 7th). I felt it was important to have her in this video because she started out in JP as a very passionate member. She continues to utilize that passion with her new role in JP. You can tell that not only does she understand the role that the organization plays in the lives of all the children that receive Josh Kits, but also the role that the organization can play in the lives of students who become involved and give back to the community.
Without further adieu...The Josh Project Promotional Video.
After finals, Jarrod flew down to the island and helped me and the pets get back to Ohio. But before we left we had some fun around the island :D
Where our journey together began
Ziplining with Sky Safari St. Kitts! It was our first time and it was such a blast!
We stopped out at Major's Bay. Neither of us had been to this beach before. It was very quiet and so beautiful.
We had dinner together at The Beach House Restaurant.
We stopped by the Dorset's home and enjoyed some coconuts right off their trees as well as some homemade Hammon (local moonshine St. Kitts style). I already miss them and their family cat "Puddy" very much. But will keep in touch with them and hopefully visit again one day. I'm so grateful I met them at that one RUSVM Open House that I volunteered at. They were so kind and I can't wait to see their son pursue his dream of becoming a veterinarian.
Traveling wasn't too bad. We overnighted in Miami and stayed at the airport hotel. Overall all the pets did really well and it wasn't horribly stressful. We arrived pretty late to the Cincinnati airport but everyone got settled in really well.
Where did I sleep?? Oh I found room on the pull out of course!
My gorgeous handmade gift from my Uncle Jay...best present EVER!
My new ride in the states!
Packed up and ready to move up to Columbus (again)
All 7 pets are in the car (4 cats and 3 dogs) and ready to go.
Go Bucks!!
Yup, people stare at us but I love these goobers and they love their short walks together around our new neighborhood.
Cats get along for the most part lol and yes they have a whole room to themselves.
I finally live where I have a great view of a sunrise :)
My transition to Ohio State has been so easy. All the students in the class that I have joined are absolutely amazing and so helpful. I do have to admit the hardest transition for me coming back to the states has been grocery shopping. The stores are huge and there's everything and anything you could ever need in one store. I have gotten to see most of my best girl friends since I've been back. I wish I had more time to hang out with them but they are all very understanding of my schedule in clinics and how limited I am with time to do much else other than study VetPrep and my rotations. Sadly I had to say good-bye to my bestie, Caitlin, shortly after my return to Ohio as she set off to start her journey towards pursuing specializing in small animal internal medicine with a small animal rotating internship at Texas A&M. But we are pros at distance and keeping in touch and I definitely see a visit to see her in my future :)
My clinical year has been amazing so far. I started off my time at Ohio State in an Applied Pathology rotation. It was extremely educational and I loved all the disease processes that we got to see when we did autopsies that did reveal lesions. I do have a word of advice to all those that go through these rotations that perform autopsies...bring Vick's Vapor Rub. Helped so much getting through this rotation. This rotation definitely gave me an appreciation for the peace of mind it was able to give veterinarians and the owners of the animals we worked on. Many owners wonder if they made the right choice by humanely euthanizing their pets...was it the right time...etc. And in performing an autopsy, we were able to give them answers to these concerns. Often times, the answer was yes...you definitely made the right decision. And lastly, the reports that we had to do for all the autopsies that we were primary for really helped solidify the diagnosis and pathophysiology behind the lesions that were found.
My second rotation was with Oncology. I was not sure what to expect with this rotation and was honestly nervous about it. What this rotation enabled me to have is more confidence with preliminary diagnoses of cancer, types of cancer and their characteristics, the approach to these cancers and what expectations you can have with the different treatment options. I was extremely impressed with the clinicians I worked under during this rotation. The department also has ongoing research studies that are contributing to improvements with canine and feline cancers. It was very cool to see these projects. The rotation also solidified a variety of ways to utilize the diagnostics available to us with cancer patients. It was also very humbling to be present when the clinicians were discussing a diagnosis and options to pet owners.
My third rotation at OSU was Equine Surgery. We hit the ground running during this rotation! My first day I was assigned 5 inpatients during our rounds. I do feel like I got the hang of what was expected during this rotation and how to manage treatments, SOAPs, discharges, surgery reports, etc...might have taken the whole rotation, but I strived each day to do it to my clinician's liking! The clinician that I mainly worked with definitely had high expectations of his students, but personally it only made me work that much harder every day to hopefully make him proud of my efforts and progress throughout the rotation. This rotation was also awesome because....it was SURGERY!! I really have a special place in my heart for surgery. During this rotation I met two blood donor horses that I grew to really love. I also made sure that they got all the TLC I could give during my two weeks on this rotation. All the clinicians and staff that I got a chance to work with during this rotation were really awesome and I can't wait to work with them again in September.
My fourth rotation was Anesthesia. I really loved this rotation. I loved the challenges that each patient presented when coming up with a safe anesthetic protocol to use during their procedures. The technicians and clinicians were amazing to work with. They really enabled you to become more confident in your drug selections, anesthesia set up, intubation, IV catheter placement, monitoring, etc. Most days you are doing small animal anesthesia but you do get 1-2 days of large animal anesthesia. I switched with a rotation mate to get a second day with the large animal anesthesia team because I really had a lot of fun with the large animals since I wasn't getting to work on them all the time during this rotation. Overall, the rotation was just so satisfying because you really had to put some knowledge to use and you also got to fine tune your clinical skills.
For my fifth and sixth rotations I have been off-site at Metropolitan Veterinary Hospital in Copley, OH. I've been staying with a veterinarian and her family for the past month. We actually became facebook friends in 2011 because we had mutual facebook friends and a love for Greater Swiss Mountain Dogs. We've kept in touch all these years and she helped me get in touch with the folks at Metro to land my externship. I have spent a week with ER, a week on internal medicine, and my last two weeks have been with orthopedic and soft tissue surgery. ER was intense but a good introduction to how it will probably be at Ohio State when my ER rotation rolls around. I've really enjoyed working with all the technicians, clinicians, interns, and residents during my time at Metro. One of the interns is a Rossie, one of the surgical interns is a Rossie, and one of the surgical residents is a Rossie...small world! So it was good to see some familiar faces while I have been there.
Aside from gaining insight into a referral hospital and being able to observe client interactions in this setting, I've also been able to have some down time this past month. I've been able to really kick my NAVLE studying into the next gear and have made a ton of progress with my VetPrep material. I have also been able to go to Cedar Point for the first time over a weekend. I went to my first country concert and saw Toby Keith perform after tailgating of course. And I went to my first deep fry cookout...YUM! Hanging out with my hostess and her family has been a blast and I'm soooooo very thankful for her hospitality this past month. None of this would have been possible if she hadn't allowed me to stay with her during my externship.
This past month has also been a time of reflection for me. As I've mentioned before, I have a soft spot for small animal surgery. I had given thought to pursuing a rotating small animal internship in hopes to begin the journey towards specializing in small animal surgery. This rotation allowed me to speak to others that are on that journey, to speak to those that have even been in general practice prior, and to speak to those that I know are currently in general practice. I really picked their brains and after some contemplating on the pros and cons of the small animal surgery path, I've decided to put pursuit of this path on hold temporarily. Jarrod is in the midst of an equine rotating internship at KSU as of June of this year and he has hopes to landing an equine surgery residency in this next year. Long story short, we are both exhausted with spending our relationship apart and I've decided to find a small animal general practice job where ever he ends up for his residency (fingers and toes crossed he is scooped up by someone during this next match period!). So he will enter the match program that matches internships and residency positions and hopefully come February of next year we will know more! And Jarrod knows that if and when I decide to pursue small animal surgery, he has to come along for the ride :) But who knows...maybe I will find that general practice is an even better fit for me! I'm keeping my mind open :)
I am really excited about not only being with him come next June, but also being in general practice where I will get to be an amazing advocate for my patients and even perform surgeries. But that is a little ways away so I'm trying to remain focused on the immediate hurdles I have to clear first...the NAVLE! Wish me luck and I will continue to keep all of you posted on my time at Ohio State and all that is to come in the next 9 months of clinics!
Monday, March 3, 2014
Organized Chaos
The traditional 7th semester class photo
~Clinical Placement~
First, some amazing news to share...I got my top choice for clinical placement and am heading back home to finish my clinical year at THE Ohio State!!!
Karla and I celebrating after finding out my placement
~Intro to Clinics~
Since my last post I've had several Intro to Clinics rotations so I'll run through those with you all.
I got my review of my Small Animal Surgery rotation and am really happy with it. The clinician is a difficult one to impress, so being marked for meeting the expectations is GREAT!
For week 4, I was on Communications. I was skeptical about this rotation but very happy that I was a part of it. Elpida is the passionate and extremely knowledgeable coordinator and does an amazing job providing real life scenarios with clients, discussing all aspects of communications, and giving constructive feedback to students. The rotation was a 2 day rotation (Monday and Thursday). Both days we were given scenarios to discuss and one student would role play with a "client". From discussing cryptorchidism in a dog to giving the diagnosis of lymphoma, we had great exposure to various topics.
Week 5 was my Equine rotation week. I was honestly so excited to be back around horses. I was assigned one of the campus horses, Kassara, and had to SOAP her on specific days of that week. On our first day of the rotation we were thoroughly introduced to the rotation and discussed various lameness exam topics. Kassara was lame the week I took care of her and had a moderate case of "rain rot" (the "winter" season here is known for causing this among the university's horses). Every AM and PM I would SOAP Kassara and work with the on-call clinician on updates with her condition as well as her treatments. I was able to help her "rain rot" slightly by giving every other day iodine scrub baths (taking care to not get the bandage on her left front hoof wet). Kassara had a left front lameness that was localized to an area in her hoof. Care was taken to provide her with pain relief and proper dressing/bandaging on the affected hoof. It was later emailed to me during week 6 that a subsolar abscess was finally found, drained, and treated allowing Kassara to show 70-80% improvement immediately after. I see her every day when I am out SOAPing my sheep and donkey and she seems to be doing great so I'm really thrilled that it resolved! I had never seen a horse with that kind of lameness so it was a great learning experience.
Week 6 was Bovine 1 rotation (one day rotation). We got a nice introduction to approaching cows, pointing out their kicking zones, where are safe places to stand when working with cows, performing a flank hold, how to make a cow urinate, tail jack techniques and how to steer a cow using their tail, applying a belly cinch in front of the udder, applying flank hook and Kow Kan't Kick kicking restraints, High/low tail ties, casting rope (half hitch method), placing a halter correctly, restraining their head using a halter and halter tie, safe use of nose tongs, passing oro-ruminal tubes (EWWW!), catching and restraining calves (cute little buggers!), herding cattle, and operating a cattle chute. By far the most intimidating species I've had to work with yet!! These cows are HUGE! I loved the experiences during this rotation and the knowledge it equipped me with, but I'm not sure that I will ever make a career working with this species!
Week 7 was my Small Animal Clinic rotation (one day). I was given an appointment and worked with one other classmate. The appointment was a vaccine appointment (the client was actually a classmate of ours getting her cat ready for traveling back to the states in April). This experience gave us an opportunity to demonstrate our physical exam and client communication skills and communicate our findings and plan with the clinician that was overseeing the rotation.
Week 8 I had no rotations!
Week 9 (current week) is my anesthesia rotation so I prepped all weekend reviewing material from 5th semester (focusing on drugs and their side effects). I'm excited for this rotation and working with Dr. Simon on our cases/patients. I did a physical exam along with the surgeons on a ~1 year old male, mix breed dog who is undergoing a castration on Thursday. I created an anesthesia protocol for him, had it approved and discussed some aspects of it with Dr. Simon, and will carry it out on Thursday all by myself!
~Large Animal Procedures~
Now that I've ran through my rotations, I'll run through the procedures with our sheep (we've worked on two) and donkey that I've participated in with my SOAP group. The best part of all of these is that there are clinicians/technicians right there during your entire procedure. With anesthesia, you are responsible for meeting with your assigned clinician/technician at least 3 to 5 days prior to the procedure and having an anesthesia protocol already written up and properly presented.
Week 4: Arthorcentesis procedure on our donkey. I performed an arthrocentesis on the radiocarpal joint. Really great experience and fairly easy if you know your anatomy.
Week 5: I managed our sheep's entire anesthesia for his epididectomy/castration procedure. Anesthesia is kind of intimidating to me but I was successful in creating a solid anesthetic protocol and carrying it out without any complications that required intervention (ie. IPPV, fluid bolus, etc.). Anesthesia for these procedures means that you create a pre-med, induction, and maintenance protocol. You also are in charge of monitoring various vitals on your patient while they are under (ie. systolic/diastolic/mean blood pressure, respiratory rate, heart rate, temperature, PCO2, fluid volume given, etc. are recorded at 5 or 15 minutes). It is your job to set up and check all the equipment before the procedure as well as place all the various monitors once the patient is successfully intubated by YOU. Anesthesia is a lot of calculations, understanding the effects of the drugs you have given, recording/documenting, and having a plan when something of concern arises.
Week 6: I managed the anesthesia for our donkey during his nerve identification procedure. I gave an abaxial nerve block for my partners to work on the medial palmar digital nerve of the left front leg. While my partners did the surgical aspect of the procedure, I carried out my anesthesia protocol. Hypotension tends to be a common complication of anesthesia with the large animals. I had to bolus IV fluids as well as give a couple doses of ephedrine during the procedure to help our donkey maintain a safe systolic blood pressure. His recovery was a little exciting because he was pretty ready to move around when he finally stood up with our help, but we stuck with him and kept him safe until he was ready to go back to his pasture.
Week 7: I was the primary surgeon for our sheep flank skin incision. I made a 6" incision on the left flank of our sheep that went no deeper than the cutaneous trunci. After incising through the appropriate layers, I performed a simple continuous suture pattern to close the cutaneous trunci layer. I then used a ford interlocking pattern for the proximal half of the skin and then placed horizontal mattress patterns for the remaining half of the incision. There was great skin apposition and our sheep healed wonderfully!
Week 8: I was selected by another group to be an assistant surgeon for their skin incision lab. I helped them set up their anesthesia equipment and get their sheep ready for the procedure. I scrubbed in but only to assist and observe so the primary surgeon of the group could do the entire procedure. After the procedure, I helped clean the entire surgery area that the group occupied and then went on my merry way. I did get one of the best compliments from the primary surgeon that I have had all semester. She told me that I made her extremely comfortable and confident to the point that her hands were more steady than they have been in past procedures. OH! How could I forget! The best part of this procedure.....we had multiple power outages and periods of working with no lights except the sun that was coming in through the surgery suite's windows (luckily we had a table by the windows)!! I had to just assist the surgeon by holding the suture so she could see it better (dark suture on a dark colored patient in the dark). Funniest thing about the whole experience, when the lights did go out throughout the procedures, no one flinched...no one missed a beat...the show went on! And that's what it means to be a Rossie!!
Week 9: Tomorrow is our casting lab for our donkey (I'm an assistant). We will place a cast on our donkey, allow it to set, and then remove it before we wake him up from general anesthesia.
~Bovine Palpation and Beyond~
So we have consistently had a bovine palpation lab every week since the semester started. The good news is that I've been able to identify all the structures of a cow's reproductive tract (cervix, uterus, uterine horns, ovaries and associated structures such as corpus luteums and follicles, and if the cow is pregnant, attempting to determine how far in her pregnancy she is). Some palpation sessions are more frustrating than others because you may not be able to identify or correctly take measurements. Every cow is different! As I said, you have to take various measurements of the cow's that you palpate. You are supposed to try to correctly measure the cervical diameter and the diameter of the base of both uterine horns. How in the world do we do this? With our finger tips! I measured the length of my index finger tip (1.5 cm) and then my index finger plus my middle finger tips (3 cm) and then my index, middle, and ring finger tips (~5 cm). Aside from bovine palpation, we have also had an obstetrics lab (learning about different presentations of the calf at birth, how to use chains and various other tools in assisting the cow with giving birth, etc.), sheep ultrasounding, and this week (week 9) we are having a fetotomy lab.
~Everything Else!!~
Aside from all the things I've already talked about, I've also been juggling getting my pets ready for traveling out of the country in April. Ting decided to get injured by pulling a dresser on top of her when I wasn't home at the beginning of the semester and ultimately needing a femoral head osteotomy for the dislocated hip she acquired. She's on the road to recovery (could take up to 6 months for full recovery). As much as it sucks to have to have gone through all of this...I'm just so thankful she's alive and nothing worse happened (ie. paralysis, etc.).
Ting showing off her shaved leg
The coconut retrievers decided to give me a scare and eat something out in the yard that I wasn't totally sure about so I ended up being an over protective pawrent and getting blood work to confirm it was in fact NOT rat poison. I have good reasons to being an over protective owner because in St. Kitts it's not uncommon for dogs to be poisoned via rat poison whether it is hidden in some kind of food or not.
How could I be mad at these faces??
We had our 6th and 7th semester beach party out at Banana Bay. It was so much fun!! I love my orange semester classmates!
I was able to find an apartment to rent for my clinical year (and will be living fellow Rossies so we can hopefully help each other out if needed) that has some great features and am slowly gathering furniture/supplies to fill it with. I also have an SUV to come home to thanks to Erin (a vet tech that has known me forever and works with my aunt) and my aunt.
Good-bye my awesome island car...I'll miss you, Meg's Egg!
Hellooooo sexy SUV!
My mornings that I SOAP usually start like this...
And end like this (well sometimes I get to go to the beach)...
Earlier in the semester I rescued a pup off the streets. She was limping on the main road across from campus one morning and on my way home that evening she was still wandering around. She let me approach her and I took her to the VTH to get looked at. Luckily all that she had was a torn up paw pad. So she stayed with me briefly and I was able to find her a forever home (YAAAAAAAY!). She is living at a foster home currently that is giving her tons of love and care since my schedule is toooo crazy to really give her all the attention she deserves. She was originally named Kanga (short for Kangaroo) but now is rightfully named Penny (after Penny from Big Bang Theory) by her forever momma.
I have been working my butt off all semester to finish the Josh Project "Under the Sea" mural painting at the pediatric ward and am happy to say that it is one more session away from being COMPLETE! Stay tuned for a blog entry on that entire experience and project!
Jen and I with the mural (one session away from completion!)
All my current classes are going really well...not that I didn't expect them to but we are so busy this semester, it is definitely challenging to throw studying for classes in the mix! We have 43 days left in the semester and I know they are going to continue to fly by. There's still a ton left to do this semester in regards to rotations and procedures so stay tuned as I wrap up my time on the island!
Monday, January 20, 2014
"On an Island Being the Change You Wish to See in the World"
I found out over December break that I had been selected as the winner of the "Experiences" category in The Vet Gazette for an article that I submitted to them. I was so thrilled that my article got a spotlight on VG! I wrote the article to discuss the successes of 2012 for RUSVM's Josh Project and the recognition that we received, but also to hopefully encourage others to become active in their own communities in any way they could. I hope my article continues to inspire others to serve those around them, and I will strive to continue to inspire those I meet along the way as I find ways to reach out and help those around me no matter where my life takes me.
"On an Island Being the Change You Wish to See in the World"
"On an Island Being the Change You Wish to See in the World"
7th semester...I made it!!
Before I talk to you about how amazing, surreal, and exciting 7th semester has already been (currently in our 3rd week), I realize that I neglected to really compose much in regards to 6th semester so I'll briefly discuss it and the challenges that I faced.
6th semester has a couple of intimidating hurdles in store for you and you tend to hear about them way before you even reach 6th semester because they are just that notorious. Since 1st semester you have been working on your surgical skills and getting your hands to recognize these new motor skills and perform them without even thinking. In 6th semester you finally get to put these skills together and you are tested via the ROSSie (a spay model). The ROSSie attempts to mimic all the layers of your patient's abdomen as well as the reproductive organs (although now that I've actually performed an OVH on a live patient I can honestly say that this model is nothing like live tissue but it will prepare you in regards to the ligatures/etc that you use during your OVH surgery). If you practice, practice, practice, and then practice some more...you will do really well with this. Along with your surgical skills being checked off by surgeons at RUSVM, you also will be tested on your working knowledge of various anesthesia topics. In my case, I did prepare probably more so than the rest of my classmates simply because I had taken an entire semester off from anesthesia and didn't want to struggle at the examination. The A-team (anesthesia team) was very straight forwards and the examination varied depending on which clinician you were paired with, but overall it was a very fair review of some key topics you should have a grip on prior to entering 7th semester when you will be entirely responsible for the anesthesia of your patient (being the sole anesthetist in many small and large animal surgeries).
Last but not least, BLOCK EXAMS. I have mixed feelings about blocks. The first two blocks for my semester were fair and I was told to do really well on them because the 3rd and 4th blocks could be rough. So I listened to the wise words of those that had come before me and did well on the first two blocks. I studied hard for both the 3rd and 4th block but still struggled. Going into finals I had one goal on my mind...to either maintain or increase my overall GPA. At the end of the semester I was able to actually increase my overall GPA and therefore still be able to apply to the schools I wanted to apply to for clinics (I'll talk about this later).
I was really happy with how my 6th semester went as well as the end results. It was the first semester that I was able to really focus on my studies because I had removed myself from being chair of Josh Project and taken on a less time demanding project (the mural painting project at the pediatric ward that I'll blog about in the near future). I have no regrets with how I submerged myself in all things Josh Project in previous semesters! I honestly am so happy I took the time and energy to focus on something outside of my coursework that would contribute to not only the RUSVM community but most importantly the St. Kitts community. But in realizing that my grades weren't necessarily the best reflection of my potential, I did decide to step away and really put all my effort into having a successful, on paper, semester.
ON TO TALKING ABOUT 7TH SEMESTER!!
Prior to the end of 6th, we actually gave preferences for our introduction to clinics rotations. You will have mandatory rotations (ie. equine, bovine, small animal clinic, clin path, emergency, etc.) and then you will have a choice of elective rotations (ie. anesthesia, therio, small animal surgery, ambulatory medicine, primate research, rehabilitation therapy, acupuncture, diagnostic imaging, etc). I am really thrilled about the rotations I was able to get (it's up to a computer system after you submit your rankings). For my elective rotations I received small animal surgery, anesthesia, dentistry, communications, and diagnostic imaging. Each week you are on a different rotation. Some are a day long, a couple days long, or the entire week. My first rotation was small animal surgery during my second week. I met my patient on Monday of the second week and did a complete physical exam as well as blood work and then completed all the paperwork that followed (ie. SOAP form, discharge instructions of findings from the PE and blood work, etc). My patient was an intact male cat that was less than a year old and presenting to us for a feline castration procedure. The procedure was then carried out by me as his sole surgeon on Thursday. The surgery went great and I am overall really thrilled about this rotation and how hands off the clinicians were. You were expected to treat it as YOUR patient, YOUR surgery, and YOUR paperwork. I prepped appropriately for this surgery by reading through the small animal surgery book as well as rounding with the overseeing clinician on the procedure. I had never performed a feline castration let alone been given the responsibility of an entire case. It was very exciting to have the opportunity to put my knowledge to the test and being as thorough as possible for the entire rotation. I decided to perform an open castration on my patient and use a figure 8 knot to tie the pampiniform plexus to both testicles.
During my first week, I received my surgery lab partners (4 of us total; 2 surgeons and 2 anesthetists) and also found out just prior to the start of the semester that I would be acting as one of the surgeons for a canine OVH procedure on the Friday of the second week. On the Wednesday of the first week, we received our patient and all four of us performed a thorough physical exam as well as drew blood for the blood work. We gave our patient a tentative diagnosis of Ehrlichia which is actually pretty common for the dogs living on the island. Ticks, that usually carry Ehrlichia, are very rampant with the island climate. She was sent home with the appropriate medication and we provided information to the owner. Our patient had to come back for a recheck blood draw at which time we had to evaluate other blood values that were out of the normal ranges. Our patient was approved for her OVH surgery for the Friday of the second week after the platelets had improved and met the surgical/anesthesia requirements. The surgery went really well and like I stated above, our ROSSie model did nothing to prepare us for how real live tissue is to work with. The good news is that you have the surgical skills to carry out the procedure and you have some amazing clinicians overseeing the entire procedure (as well as the technicians at the hospital...they are just awesome). My surgery partner and I began practicing together the moment that we found out we were going to be performing the procedure together (so that previous Wednesday). We even went to the anatomy lab and pulled out a specimen with intact female repro tract and structures. We reviewed the anatomy of the abdomen and the layers we would be cutting through. I mean we really prepared to the best of our ability for our OVH procedure. We were also given a bucket that was similar to the ROSSie but allowed us to practice the intradermal suture pattern (which we learned in a week).
Overall the experience was amazing. It was scary and intimidating working on a live patient but very exciting to be allowed to have this learning experience. I can honestly say that I think this is one of those scenarios this semester that it really is a group effort. My partner was just as driven and determined as I was to be as prepared as possible. Our chemistry as a duo has really made all the difference as well. Prior to this team up, I had not interacted with her because I was still a fairly new addition to orange semester. We worked extremely well together and our anesthetists did a great job preparing for our procedure as well as keeping our patient on a perfect plane of anesthesia the entire procedure.
I'm also very thankful for having a case/patient that presented with some health issues that required me to really put my thinking cap on to work it all up and record the findings appropriately. My feline castration was healthy as he could be and so I was really thankful that my OVH patient came with a few lessons to teach me as I put my 6 semesters of knowledge to the test. I know that I will probably never forget my OVH patient and the lessons she taught me.
This week is my diagnostic imaging rotation which was only from 1p-4p today (Monday). We did an ultrasound on a healthy kennel dog and all of us took turns locating the right and left kidneys, the spleen, the liver and gallbladder, the urinary bladder and prostate, and noting the stomach and intestinal tract. We also observed a cardiac ultrasound on a young cat with a heart murmur. Loved seeing the heart and all the different views and areas that we really focus on to diagnose cardiac diseases! Dr. Du Plessis also joined us to echo a young cat and it was really a great opportunity to watch her in her element and have her share her insights on the case. We were also able to check out a digital radiograph of a femoral fracture repair via plate and cerclage wire on a young dog that had just been in surgery for this repair and discuss the case briefly with the surgeon.
So as I stated above you have an OVH surgery that you work with three other classmates on (2 will do the surgery and 2 will do the anesthesia). You have two OVH procedures and act as a surgeon for one and an anesthetist on the other. I also have a SOAP group that consists of myself and two other classmates. This group is in charge of SOAPing a donkey (Spanky) and sheep (Thor) that we have been assigned. In the SOAP group you also get to perform some large animal procedures. We will be doing an arthrocentesis on our donkey and I will act as the primary surgeon in this procedure. Then we do an epididectomy surgery on our sheep and I will act as the sole anesthetist. We will do a nerve identification procedure on our donkey and I will also be the sole anesthetist for this procedure. I will be the assisting surgeon for two incision procedures (once with my group and then volunteer for another group). I will also act as an assisting surgeon on our casting procedure. And then last but not least, I will be the primary surgeon on our sheep celiotomy and typhlotomy.
Aside from these two groups that I'm working with, I'm also in a different group of six others that will be presenting on the topic of the interpretation of fractional excretion of sodium during one of the scheduled grand rounds days this semester (7th semester students present a variety of topics to 6th, 7th, and other semester students). We met the other day and got our outline for our presentation on paper and the topics are divvied up as well. Our goal is to collaborate with some of the professors that may have some cases or information that will help us to make our presentation as exceptional as possible. I'm actually really excited about this topic because it's not one that I know a great amount about so I will get a chance to teach others at this presentation all that I've learned from researching this topic and hopefully provide them with valuable and useful information to use not only in school but beyond.
So that's it for now! My feet literally hit the ground running when 7th started, but it has been right up my alley. I love being busy. I love feeling a little chaos at times. And I love putting my organizational, problem solving, and veterinary skills to use! I will attempt to update my blog as the weeks roll by. I'm really excited about all the amazing opportunities that this semester has in store as well as the countdown (85 days!!!) until I say good-bye to my island home (I will miss it dearly) and begin the next chapter of vet school. I will be finding out this coming Friday where I will be spending my clinical year ("4th year") of veterinary school. No matter where that may be, I know that I will make the best of it. I did submit my top three preferences and provided a personal explanation for my top preference, but the process is not clear cut and you don't always get your top preference let alone any of your top three preferences. I'm keeping my fingers crossed but remaining realistic about the process. I know that where ever I end up is all a part of my plan and I have to trust that.
6th semester has a couple of intimidating hurdles in store for you and you tend to hear about them way before you even reach 6th semester because they are just that notorious. Since 1st semester you have been working on your surgical skills and getting your hands to recognize these new motor skills and perform them without even thinking. In 6th semester you finally get to put these skills together and you are tested via the ROSSie (a spay model). The ROSSie attempts to mimic all the layers of your patient's abdomen as well as the reproductive organs (although now that I've actually performed an OVH on a live patient I can honestly say that this model is nothing like live tissue but it will prepare you in regards to the ligatures/etc that you use during your OVH surgery). If you practice, practice, practice, and then practice some more...you will do really well with this. Along with your surgical skills being checked off by surgeons at RUSVM, you also will be tested on your working knowledge of various anesthesia topics. In my case, I did prepare probably more so than the rest of my classmates simply because I had taken an entire semester off from anesthesia and didn't want to struggle at the examination. The A-team (anesthesia team) was very straight forwards and the examination varied depending on which clinician you were paired with, but overall it was a very fair review of some key topics you should have a grip on prior to entering 7th semester when you will be entirely responsible for the anesthesia of your patient (being the sole anesthetist in many small and large animal surgeries).
Last but not least, BLOCK EXAMS. I have mixed feelings about blocks. The first two blocks for my semester were fair and I was told to do really well on them because the 3rd and 4th blocks could be rough. So I listened to the wise words of those that had come before me and did well on the first two blocks. I studied hard for both the 3rd and 4th block but still struggled. Going into finals I had one goal on my mind...to either maintain or increase my overall GPA. At the end of the semester I was able to actually increase my overall GPA and therefore still be able to apply to the schools I wanted to apply to for clinics (I'll talk about this later).
I was really happy with how my 6th semester went as well as the end results. It was the first semester that I was able to really focus on my studies because I had removed myself from being chair of Josh Project and taken on a less time demanding project (the mural painting project at the pediatric ward that I'll blog about in the near future). I have no regrets with how I submerged myself in all things Josh Project in previous semesters! I honestly am so happy I took the time and energy to focus on something outside of my coursework that would contribute to not only the RUSVM community but most importantly the St. Kitts community. But in realizing that my grades weren't necessarily the best reflection of my potential, I did decide to step away and really put all my effort into having a successful, on paper, semester.
ON TO TALKING ABOUT 7TH SEMESTER!!
Prior to the end of 6th, we actually gave preferences for our introduction to clinics rotations. You will have mandatory rotations (ie. equine, bovine, small animal clinic, clin path, emergency, etc.) and then you will have a choice of elective rotations (ie. anesthesia, therio, small animal surgery, ambulatory medicine, primate research, rehabilitation therapy, acupuncture, diagnostic imaging, etc). I am really thrilled about the rotations I was able to get (it's up to a computer system after you submit your rankings). For my elective rotations I received small animal surgery, anesthesia, dentistry, communications, and diagnostic imaging. Each week you are on a different rotation. Some are a day long, a couple days long, or the entire week. My first rotation was small animal surgery during my second week. I met my patient on Monday of the second week and did a complete physical exam as well as blood work and then completed all the paperwork that followed (ie. SOAP form, discharge instructions of findings from the PE and blood work, etc). My patient was an intact male cat that was less than a year old and presenting to us for a feline castration procedure. The procedure was then carried out by me as his sole surgeon on Thursday. The surgery went great and I am overall really thrilled about this rotation and how hands off the clinicians were. You were expected to treat it as YOUR patient, YOUR surgery, and YOUR paperwork. I prepped appropriately for this surgery by reading through the small animal surgery book as well as rounding with the overseeing clinician on the procedure. I had never performed a feline castration let alone been given the responsibility of an entire case. It was very exciting to have the opportunity to put my knowledge to the test and being as thorough as possible for the entire rotation. I decided to perform an open castration on my patient and use a figure 8 knot to tie the pampiniform plexus to both testicles.
During my first week, I received my surgery lab partners (4 of us total; 2 surgeons and 2 anesthetists) and also found out just prior to the start of the semester that I would be acting as one of the surgeons for a canine OVH procedure on the Friday of the second week. On the Wednesday of the first week, we received our patient and all four of us performed a thorough physical exam as well as drew blood for the blood work. We gave our patient a tentative diagnosis of Ehrlichia which is actually pretty common for the dogs living on the island. Ticks, that usually carry Ehrlichia, are very rampant with the island climate. She was sent home with the appropriate medication and we provided information to the owner. Our patient had to come back for a recheck blood draw at which time we had to evaluate other blood values that were out of the normal ranges. Our patient was approved for her OVH surgery for the Friday of the second week after the platelets had improved and met the surgical/anesthesia requirements. The surgery went really well and like I stated above, our ROSSie model did nothing to prepare us for how real live tissue is to work with. The good news is that you have the surgical skills to carry out the procedure and you have some amazing clinicians overseeing the entire procedure (as well as the technicians at the hospital...they are just awesome). My surgery partner and I began practicing together the moment that we found out we were going to be performing the procedure together (so that previous Wednesday). We even went to the anatomy lab and pulled out a specimen with intact female repro tract and structures. We reviewed the anatomy of the abdomen and the layers we would be cutting through. I mean we really prepared to the best of our ability for our OVH procedure. We were also given a bucket that was similar to the ROSSie but allowed us to practice the intradermal suture pattern (which we learned in a week).
Overall the experience was amazing. It was scary and intimidating working on a live patient but very exciting to be allowed to have this learning experience. I can honestly say that I think this is one of those scenarios this semester that it really is a group effort. My partner was just as driven and determined as I was to be as prepared as possible. Our chemistry as a duo has really made all the difference as well. Prior to this team up, I had not interacted with her because I was still a fairly new addition to orange semester. We worked extremely well together and our anesthetists did a great job preparing for our procedure as well as keeping our patient on a perfect plane of anesthesia the entire procedure.
I'm also very thankful for having a case/patient that presented with some health issues that required me to really put my thinking cap on to work it all up and record the findings appropriately. My feline castration was healthy as he could be and so I was really thankful that my OVH patient came with a few lessons to teach me as I put my 6 semesters of knowledge to the test. I know that I will probably never forget my OVH patient and the lessons she taught me.
This week is my diagnostic imaging rotation which was only from 1p-4p today (Monday). We did an ultrasound on a healthy kennel dog and all of us took turns locating the right and left kidneys, the spleen, the liver and gallbladder, the urinary bladder and prostate, and noting the stomach and intestinal tract. We also observed a cardiac ultrasound on a young cat with a heart murmur. Loved seeing the heart and all the different views and areas that we really focus on to diagnose cardiac diseases! Dr. Du Plessis also joined us to echo a young cat and it was really a great opportunity to watch her in her element and have her share her insights on the case. We were also able to check out a digital radiograph of a femoral fracture repair via plate and cerclage wire on a young dog that had just been in surgery for this repair and discuss the case briefly with the surgeon.
So as I stated above you have an OVH surgery that you work with three other classmates on (2 will do the surgery and 2 will do the anesthesia). You have two OVH procedures and act as a surgeon for one and an anesthetist on the other. I also have a SOAP group that consists of myself and two other classmates. This group is in charge of SOAPing a donkey (Spanky) and sheep (Thor) that we have been assigned. In the SOAP group you also get to perform some large animal procedures. We will be doing an arthrocentesis on our donkey and I will act as the primary surgeon in this procedure. Then we do an epididectomy surgery on our sheep and I will act as the sole anesthetist. We will do a nerve identification procedure on our donkey and I will also be the sole anesthetist for this procedure. I will be the assisting surgeon for two incision procedures (once with my group and then volunteer for another group). I will also act as an assisting surgeon on our casting procedure. And then last but not least, I will be the primary surgeon on our sheep celiotomy and typhlotomy.
Aside from these two groups that I'm working with, I'm also in a different group of six others that will be presenting on the topic of the interpretation of fractional excretion of sodium during one of the scheduled grand rounds days this semester (7th semester students present a variety of topics to 6th, 7th, and other semester students). We met the other day and got our outline for our presentation on paper and the topics are divvied up as well. Our goal is to collaborate with some of the professors that may have some cases or information that will help us to make our presentation as exceptional as possible. I'm actually really excited about this topic because it's not one that I know a great amount about so I will get a chance to teach others at this presentation all that I've learned from researching this topic and hopefully provide them with valuable and useful information to use not only in school but beyond.
So that's it for now! My feet literally hit the ground running when 7th started, but it has been right up my alley. I love being busy. I love feeling a little chaos at times. And I love putting my organizational, problem solving, and veterinary skills to use! I will attempt to update my blog as the weeks roll by. I'm really excited about all the amazing opportunities that this semester has in store as well as the countdown (85 days!!!) until I say good-bye to my island home (I will miss it dearly) and begin the next chapter of vet school. I will be finding out this coming Friday where I will be spending my clinical year ("4th year") of veterinary school. No matter where that may be, I know that I will make the best of it. I did submit my top three preferences and provided a personal explanation for my top preference, but the process is not clear cut and you don't always get your top preference let alone any of your top three preferences. I'm keeping my fingers crossed but remaining realistic about the process. I know that where ever I end up is all a part of my plan and I have to trust that.
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