It was kind of like owning a horse again… I had to do physical exams and get vital parameters (temperature, pulse and respiratory rates, etc.) on her twice a day, administer medications, groom her, make sure she had clean water and that she was comfortable.  We ended up doing a TON of diagnostic work on her to find that she had some “chips” that we ended up removing via arthroscopy.

I thought she was going to be crazy and wired because she was coming straight off the track.  According to her records, she raced last earlier this year then we assume she was given some time off then re-worked because there’s a recorded workout.  Her times must not have been up to par because she came to us shortly thereafter.  Don’t get me wrong… she was still a young Thoroughbred mare, but she was SO sweet and I completely fell in love with her.  I was able to do my physical exams and get her vitals measured while she hung out eating hay.  I hand-walked her and hand-grazed her twice a day and was able to cold-hose her back leg while she grazed.  She did have some spooky moments but nothing that we didn’t both quickly recover from… and like I said, she was still a young racehorse so all that was EXPECTED.  What was unexpected was that she was SO agreeable to handle and she really enjoyed all the fussing I did with her; I groomed her meticulously every day and bathed her before surgery and she was awesome for all of it… it really made me change my perception of mares.

I don’t think I’ve ever been so sad when I had a patient discharged from the hospital yet… not even my small animal patients, which kind of has me a little perplexed.  I was seriously depressed when she left today.  We joke saying that I was a second away from running off into the sunset with her!  Now, I don’t have anymore horse patients unless I get called in for an emergency colic while I’m on-call…

Doobie’s holter results came back and he had 4 VPCs — which is good!  I can’t help but be SLIGHTLY bummed because his previous holters have all come back with 0, but 4 is definitely not bad when you come from the world of Dobermans + Dilated Cardiomyopathy (DCM).  So, we’re going to follow the hypothyroid diagnosis and re-check in a few months since he’s now on thyroid meds.  I’ll take hypothyroidism over DCM any day.

Tonight, I’m going to Bayou Country Superfest to see Tim McGraw!!!!!!!  We have seats on the field in the center so I’m excited.  The last concert I ever went to was in high school to see Live and I was all the way up in the nosebleed section!  I wanted to go tomorrow too to see Kenny Chesney but since I’m on-call, if I go, I’ll probably get called in!

River Watch — yes, the Mississippi River threatens to flood Baton Rouge and I live less than a mile from the levee so I will be one of the first to know!  But, things are looking up since they’ve opened some spillways.

Ophthalmology — this is my first rotation.  Tonight, I’m studying up on corneal ulcers for rounds tomorrow AM.  Wednesday, we’re going to be “assisting” on a corneal transplant surgery and a glaucoma-shunt (a shunt will be placed from the anterior chamber to the frontal sinus) which I’m REALLY excited about, not only are they surgeries but they’re super cool surgeries!

Louisiana-cuisine –  I ate alligator for the first time today and it really tasted like chicken.  It was blackened and dipped in a dijon sauce but it wasn’t over-cooked, apparently, so it was tasty.  Like really lean chicken… in fact, I think I prefer nicely cooked ‘gator to chicken.

Doobie — I haven’t been able to do any cardiac diagnostic work on him since we’ve been on the island (over a year) so as soon as we got to LA, I had an echocardiogram done.  His left ventricle had enlarged and seemed to have consistently enlarged over the years little by little, and in doberman-world, that’s not a good thing as Dilated Cardiomyopathy (DCM) is prevalent in the breed.  The internal diameter of his left ventricle (LVIDd; d=diastole) was 4.2 cm; greater than 4.6-4.7 cm is somewhat indicative of DCM (depending on if you have arrythmias) and in 2008, Doobie’s LVIDd was less than 4.0 cm.  So, I was concerned.  He was also due for a holter but the group holter that I have part ownership in was currently being rotated around and I needed to know sooner if he was throwing any VPCs so I had LSU run a 24-hour holter monitor on him… they have a digital one, which was way cooler than the analog one that we own.  I’m still waiting on the results of the holter.  I also had blood pulled to check his thyroid levels and he’s always threatened to be hypothyroid but was low-normal all these years so never started meds… with his echo results, I decided now might be a good time start meds.  He was started on a low dose of Soloxine last week so we’ll echo and run more bloodwork in another month to monitor everything.  If his cardiac changes are due to his hypothyroidism, there is a small chance that his heart will go back to normal function and size.

Tessa‘s back!  Luckily, Doobie & Tessa reunited and returned to their usual routine quickly.  I was afraid Doobie would forget who she was after all that time apart, but it wasn’t so.

We like our new place; we have a yard and a petsitter!  Hopefully things will work out with the petsitter because it seems I have some lonnnggg days ahead of me soon.

On the way to LA

Stopped in MS for a night

They both got echo'd... and apparently, it was an exhausting day

Doobie "loves" wearing the holter monitor for 24 hours

I think the cats like the new place

I had to include this because Tula looks like those dog toys that are only heads with two front feet with no rear end... and that she's finally come out after traumatic weeks of traveling away from the island!

For the lack of not gloating though… I had a goal and I had one semester left to do it.

Goal = met.

As much as I hate that VT is linked to that memory, the campus and community and all of the Hokie Nation have risen in ways from it that were beyond anyone’s expectations and that’s something I’m really proud to be a part of.

“We are Virginia Tech.” — Nikki Giovanni

In exactly one week from today, I’ll be leaving my beloved Caribbean home and will soon be departing to the next chapter of my life at LSU as a Tiger!  No matter, I will always be a Hokie at heart.

In 7th, we’re individually assigned a faculty or staff member to interact with in a “Mock Phone Call” as part of our Intro to Clinics II class — I got one of my Small Animal Medicine I & II professors.  I thought she was great professor; a dynamic lecturer with fair test questions.  So, I felt some pressure to do well with this mock phone call with her…

The case we were to discuss was about a young horse that she owns that presented with signs of acute laminitis due to being turned out all night to graze on lush April pasture grass when he’s usually kept in most of the time.  OK, so without the case telling me it was laminitis, it was fairly obvious considering the described clinical signs and history that was provided.  This was my 1st mistake.  I researched all aspects around laminitis down to the pathophysiologic processes at the enzymatic level and was prepared to discuss all of it!  That did not happen.

The character that my professor chose to, or was assigned to play was the ‘very novice horse owner’.  Being the dynamic professor that she is, I should have known she was going to take this role playing very seriously.  I had a really hard time with that knowing she was really someone else… in retrospect, this was probably the root of most of my mistakes.

Mistake #2.  I didn’t check the amount of minutes I had left on my phone.  Let’s rewind a little — when students arrive on St. Kitts to start vet school, the school provides you with a pay-per-minute cell phone that you buy minutes (“top-up”) for… I normally top-up with a ridiculous amount so I don’t have to do it again for a while.  It didn’t dawn on me to check how many I had left because I swore I topped-up recently.  BIG MISTAKE.  After 5 minutes into the phone call, the line cut out.  I scrambled around to find a spare phone I got from a friend that had 2.5 minutes left on it, so I charged that up and called her back (this happened about 15 minutes later because I tried to call her from my VOIP phone, but that apparently doesn’t make calls to the Caribbean… I find that weird, just billing me would be more profitable I would think).  I called her back all flustered, apologized a million times, then went back to the case… then the line cut out again. AHHHHhhhhh… so at this point, I’ve hung up on my professor twice now.

I ran all around my apartment building to see if anyone was home and found my neighbor who had minutes on his phone!  Finally, called her back AGAIN… also 10-15 minutes later… and resumed the case, yet again!

As the case went along, she said “omg… so I caused this?!?!”  I wasn’t expecting that AT ALL.  I don’t know what I was thinking because that totally threw me off and I kind of brushed it aside saying that it’s a common consequence to excessive grazing on fresh spring grass especially if the animal isn’t accustomed… Of course my initial thought was, “well, technically, yes it kind of was your fault.”

Mistake #3.  Terminology.  When I was a surgery technician, I would bring my animals in to the same clinic and of course the other technicians/doctors/4th year students knew who I was so when they were with me as a client, no one really held back when it came to explaining the procedure because they’d wave it off saying I’d probably already seen it or would be helping any way and terminology wasn’t dressed down so I would understand it better… I was only a surgical tech after all, so anything OUTSIDE of surgery was still somewhat foreign to me at that time.  This didn’t bother me a lot, but I didn’t know about everything they were saying either so I would go home and do some homework so I didn’t look stupid later.

For this case, I tried to catch myself by using layman’s terms when I could… but horse people in general tend to know what laminitis and colic mean.  But, when my “client” asked “What’s laminitis?” I started to change up my approach, and then I felt like I was talking to a child and that she would take it offensively so there was a point where I felt a very conflicted vibe about our conversation… Last minute, I ended up turning “colic” into “stomach upsets” and felt really dumb saying it.

When the conversation was over, my professor basically ripped it ALLLLLLLL apart.  It was great feedback and had I reviewed her notes on client communication rather than my Large Animal Medicine notes on laminitis then I probably would have done super!

Basically, the important points were:

• Ask open-ended questions and the client will likely tell you all about it without having to dig into specifics.  Otherwise, the client may try to answer questions in the way they think you’re going.  For example, “Tell me more about that…” versus “Is he having a hard time walking?”  So basically, avoid yes or no type questions!
• I, the “veterinarian” in the scenario, should have directed the conversation instead of asking “where were we?!?!” after we got cut off the first time — even with the fluster, I should have been the one in control of the conversation… this includes summarizing the facts of the conversation sporadically to make sure you’re on track with your client.
• Summarizing.  This needed it’s own bullet.  In my situation, I was supposed to summarize every time we re-connected.  If we hadn’t gotten disconnected at all, then sometime during the middle of the conversation this should happen and most definitely at the end.  Miscommunication is probably the most preventable aspect of client communication but often overlooked when it comes to ensuring it doesn’t happen…
• Empathy.  My professor said that I needed to at least acknowledge it rather than wave it off.  So apparently, I lack empathy… I actually used to pride myself in being able to relate with other people’s veterinary problems since I’ve encountered so many of them myself, but apparently vet school has made me a heartless individual!  Another thing I need to work on.
• Ask if the client has any questions.  OK, well if this was a REAL situation then I OF COURSE would have asked… I was seriously embarassed with the fact that this was all role-playing.
• Always state your name and position.  This is a valid point, however, one that I attempted but was abruptly cut off the first time I called because she immediately told me to call her back since her phone was going to die.  When I called her again, I figured we were past that point and I wasn’t going to re-introduce myself AGAIN… and when we started she didn’t say “action!” so I didn’t really know when we started or not… again, the whole role-playing thing got the best of me.

I used to work as a receptionist for several years during emergency hours, so I’m not a stranger to client communication with clients, veterinary students, clinicians and referring veterinarians.  You can probably imagine how HORRIFIED I was when I realized how badly that mock phone call went… maybe I need to take some acting classes?

I have so much to do and definitely not enough time to do it… especially, right now.  My house has never been so dirty before…

My surgery partner and I alternate days to SOAP our sheep (Valentino) and donkey (Garth) so that we have some kind of rest in between days to do things — this is because when you SOAP in the AM, it has to be done before class at 8 AM and also in the PM, after 4 PM but before dark… we usually have at least one surgery or anesthesia procedure during the week plus our selected rotations so we’re typically running late one of those days and that’s where our 6th semester pair comes in.  Too bad we’re all not getting along like a nice happy family.

This week, I’m on emergency rotation.  When I was a surgery technician, being on-call gave me anxiety because when my pager wasn’t going off I would stare at it thinking something must be broken and that they were trying to reach me but couldn’t for technical reasons… I was also so afraid I’d sleep through it and would wake up all stressed out and immediately grab the pager to make sure I didn’t miss a page.  It’s not like that this time… and I think it’s because I’m SO tired.

Monday was the first day of our rotation — I also had a midterm Monday AM… but for some ridiculous reason, I volunteered to take the 12 AM – 8 AM ICU shift that night!  It was uneventful and we tended to the fluid pumps and gave meds all night, but then when it came time for class on Tuesday, I thought I was going to die.  I weaved a bunch in my chair and had many head-nodding moments.  Good thing I sit way in the back!!  My poor animals, I last saw them around 11 PM on Monday night and didn’t see them again until I ran home after class on Tuesday to feed them and take a quick nap before I had to head back to SOAP my animals that PM and go to emergency rounds.  Thennn, from about 6 PM, I was on-call until 8 AM this morning.  We do things in pairs, so that makes things easier too, and luckily we didn’t get called in at all!  I’m on ICU shift again tonight from 5-12 PM and then I have to SOAP tomorrow AM at 6:30 AM.  Anyway, a couple cycles of ICU/on-call plus a Nerve Identification Surgery on our donkey on Thursday and a Theriogenology pop-quiz is the story of my life for the week!

I must love what I’m getting myself into, to be sacrificing so much sleep.  I love sleep and thankfully, I can will myself to sleep in less than 5 minutes which has been so important these past few days when I’ve only had about an hour to catch naps.

I do love what we’re doing though… the “doing” makes it all worthwhile and obviously the learning helps the doing, but I can’t wait for clinics to come so we can just do and not spend the rest of our time sitting in class!  If only 7th semester was just rotations and procedures…

Getting super-excited about LA, too — I’m thisclose to securing a place ~2 miles away from the vet school with a YARD (not huge, but STILL a yard!) annndddd a CARPORT! Hahaha!!  I always made fun of carports, but now I’m excited that my car will be dry when it rains, lol.  ANDDDD, it gets better… I’ll have my OWN washer and dryer!  After college living and shared W/D situations, having my OWN is going to be such a luxury.  Man, it feels like I’m going to be movin’ on up!

This is a really momentous occasion and the campus is already buzzing at 8:00 AM!!

I’m SO excited… the PAVE is now ‘not worth anything’ but I’m glad I took it and passed.  But NOW, I can work ANYWHERE in the U.S. — Virginia was on-board with the PAVE so that wasn’t a problem anyway, but now I can do what all the other AVMA-accredited kids can do.  SO EXCITED!!!!!!!!!!!!

News Brief: RUSVM Receives Full Accreditation by the American Veterinary Medical Association

I did reach another running goal though — I’m running a little faster now so that I’m comfortably averaging a little under a 10 minute mile.  Running with a dog is most likely the reason I have so many speed fluxuations…

A screenshot of my run today!

This little dog chases us every time we run by his/her house on the golf course… he/she’s so STINKIN’ cute that he/she doesn’t really scare us, instead I kind of want to steal him/her when I run by one day!

In other news –

I learned how to move cattle through a pen and through a chute and how to operate said chute.  I also learned how to do tail ties and make a halter out of a rope, which wasn’t too new to me, but it was fun playing with cows and rope all afternoon.   I learned how to make a cow pee… which is interesting — you basically rub their perineum and/or “bop” the bottom of their vulva simultaneously and VOILA!  They urinate and you catch it and analyze it!  The other cool thing we did was put in orogastric tubes which I managed to do all on my own because when we paired up and did it, it was a complete failure with the cow regurgitating all over us.  That was pretty foul and we all smelled like rumen.  It happened because the speculum to keep the cow from chewing up your orogastric tubing basically hit the pharynx causing a vagal reflex: vom!  Sometimes boys aren’t helpful and if you want to get it done right, sometimes you just gotta do it yourself!

The other fun thing we did today was learn how to ‘tip cows’ the professional way.  If I wasn’t so set on doing small animal surgery, I think I would totally consider playing with cows for a living… aside from the fact that a cow can give me dead arm with their rectum alone.  Let me explain that — every week we have bovine rectal palpation labs for Therio (a.k.a. Repro).  If you don’t ‘loosen her up’ back there, the cow can contract so hard down on your arm while you’re rectally palpating that it can cut off your circulation… I’ve felt my arm start to tingle and get weird.  There’s been an occasion or two where my arm was sore after lab!  Oddly, I really like that lab.