Organized Chaos

The traditional 7th semester class photo

7th semester has been flying by just like everyone told me it would!

~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

I was so thrilled when I was given this news because for me it means not just being back in Ohio, but being near several mentors that I hope to turn to during my clinical year and beyond as I determine my career path.  I was given my (tentative) rotation schedule the other week and able to also successfully secure two externships, MedVet of Cincinnati and Metropolitan Veterinary Hospital.  I don't know the exact date of my NAVLE examination but I know it will be some time in November or December and I've already purchased the VetPrep study material and am hoping to begin it in the near future.  And as you can see my rotations start on April 28th (moving to Columbus on the 23rd, orientation for clinics on the 25th)...I finish my last final of 7th semester on the 16th, fly home on the 18th (overnight in Miami) but don't arrive until the 19th...hold onto your hats!!  It's not much of a "break" between 7th and clinics, but I'm ready to rock'n'roll!  Because I have very little time between my arrival in Ohio and the start of clinics, I've been sure to get things in order before I even get back (ie. purchasing a car in the states, securing a place to live, etc).

~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!