Monday, December 27, 2010
Regretful Happenings of 2010:
My 2003 Honda Accord's transmission dies the day after Christmas 2009.
The ice and snow storm create significant water damage and headaches at the townhouse.
Matt takes a 20% pay cut for a few months in the fall.
My 1 week between 3rd and 4th year involves a trip to Boston to see my best friend, but a delayed volcanic cloud inhibits us from meeting up.
Garfield perforates his cornea during the 36 hours I am in Chicago and then endures a total of 3 eye surgeries and almost loses his right eye.
Spokane now resides with dad more than mom.
The Good of 2010:
New hybrid car that gets 40-50 MPG, but has no horsepower (or sunroof).
New hardwood floors, windows and paint job in the house.
Completed 3 academic years of vet school and try on the infamous blue senior coat.
Learned just what a trooper my Garfield really is.
Spent Friday's with Matt again for a few months.
Saw my best friend just before 2010 ends, and we vow to see each other at least once in 2011.
Travel to China for one of the most amazing cultural and veterinary experiences.
Lobbied on Capitol Hill for the welfare of animals.
Canoed the New River on a beautiful day.
Visited Jackson Hole, WY (on the downside Matt broke both wrists snowboarding).
Visited Fallingwater, finally.
Still no cavities for me.
New Hope for 2011:
A DVM degree with board certification
The right internship match
Matt's road to graduate school begins
No major illnesses for my pet family
Matt's 1997 Acura keeps on truckin'
We begin the part of our marriage where we live together again.
Isabelle gets the dental cleaning she deserves.
While 2010 created a lot of debt for us, on the whole like many hard times it made us all stronger. Who needs money anyway when you have 4 amazing pets, and a great husband. Thankfully, I'll be able to treat my own pets soon enough.
Sunday, December 5, 2010
Over vacation I got a chance to do more yoga than I have done in months, and it was amazing. I also spent time with Spokane and successfully taught her to shake, but the roll over is proving difficult. The gentle leader intro was a success as well. I saw some friends and family, but there as just not enough time spent with anyone. They will be there in May, although rumor has it I won't have too much free time either if I get an internship.
Now I begin community practice, a rotation I have been looking forward to for a while. It should be a little more like the real world then some of the other hospital rotations and propel me forward toward May 14!
In the meantime, I am in a state of limbo. With board results and the internship match program pending until early February the suspense is killing me. I am trying to channel back to 2006 when I had to wait a similar period of time to find out if I got a vet school interview. I recall the first few weeks hard to not think about it, but after that I was able to put it out of my mind. I'll miss you vacation, but with only 3 primary care rotations left I must persevere.
Wednesday, November 24, 2010
The vacation is flying by, but I have started to catch up with some old friends. I am getting a lot of sleep and am almost finished with my internship application. This weekend I will finally get to see my much-awaited Fallingwater by Frank Lloyd Wright. I am very excited. Matt will visit a graduate school he is considering. Next week I will be working out by day and externing at the Hope Center by night before heading back to school for community practice.
I have finally narrowed down my interests to general practice (there is something to be said for a balance between healthy and sick animals), emergency and critical care (it is what I know best and the initial thrill of stabilization and medicine is invigorating) and internal medicine ( I heart endoscopy). The 1 year internship will allow me to further explore these 3 fields and choose the one that is best for me. The beauty of it all, is that I know my preference may change over time, and all 3 fields are accessible with a DVM.
Here's hoping I passed the NAVLE by some miracle and get a great internship next year. It will all be known by early February, just over 2 months away.
Friday, November 5, 2010
I do truly enjoy medicine and the challenges and I absolutely love the eondscope, but again I find that the healthy patient is refreshing to see.
In the meantime, Garfield had a second prophylactic surgery in his right eye that did not go well. He had a second procedure to try to re-do the graft that seems to be doing better, but not healing as well as the other "emergency eye." I will second-guess the decision, but it is clear that that eye is diseased and we did the surgery to provide the best care for him, even if the outcome made the situation worse. Poor little cat. He has many days ahead of trips to the vet, eye medications, and e-collar fashion. Hopefully, he will not lose this eye in the end.
As NAVLE and internship application time approaches I am a little more optimistic that I will get some strong recommendations needed to secure a good internship in the Washington area.
The last week of surgery was a combined orthopedics/soft tissue service due to the surgeon conference. It was pretty busy, I got another liver case, a gallbladder rupture, which did well post-op. My last patient was an emergency and an uplifting story. A dog was found with an arrow in its chest and abdomen. We removed the arrow surgically, which miraculously did not penetrate any organs other than a small defect in the diaphragm and I got to spay her at the same time. She came in to the hospital slightly feral and panicky and left as a healthy, female spayed, super sweet dog with a true home.
Friday, October 8, 2010
My first day of the block we diagnosed a dog with splenic neoplasia and the owner elected euthanasia. My next case was the cutest Pomeranian ever. He had Adrenal Cushing's disease and came for an adrenalectomy. The mass was very large and intimately associated with the vena cava and the renal vein...out came the kidney too. His recovery was a disaster. I was with him in ICU all day until 1AM. The next morning I walked in at 6:15 to find out he had just passed. The owners were so sad but grateful. He was a legend in our hospital because he had his own human wheelchair to be pushed around. He had a ton of personality, and was loved like a child. He apparently was also included in TJ MAXX employee newsletters as their mascott.
My most promising case was a 13 year yorkie who had a liver mass removed and was doing better. 30 minutes before the owners arrived he had a seizure. We did a further workup on him the next day to find he has multiorgan failure, DIC, and half his spleen needs to be removed and he is a horrible candidate. He also likely has central vestibular (brain) disease. For lack of a better outcome he is going home to be with his owners for the time he has left.
My last case of the week is a super cool cat, with never seen before biliary cystic disease that could not be removed surgically and may not resolve medically. I got to do a lot during the surgery and place a feeding tube, but the owners are distraught over his unknown prognosis and what we don't know.
Note: All 3 cases written with owner's permission.
Between stress, lack of sleep, and poor outcomes I am depressed. Seeing Spokane last night was such a breath of fresh air. To see an healthy happy lively dog made me so grateful. I hope the coming weeks have slightly more optimistic cases. I gave me a lot to consider in terms of career choices, and dealing with death and disease on an emotional level.
I traveled to Chicago for a Pfizer career workshop and hired a cat-sitter to watch my 3 buds. When I returned home Saturday at 12 am, I found Garfield with his eye shut and filled with pus. When I attempted to open his eye he screamed and tried to bite me. I have never seen an animal in such pain. My second attempt to help him was the same. I debated whether it was an emergency, and wished I had my DVM to get him pain meds ASAP. I decided not to call the clinicians grading me at 12 AM Sat night, but did call first thing that morning. Upon exam, he had perforated his cornea due to corneal degeneration and lipid keratopathy. His other eye had extremely thin corneas as well, and is at a high risk of perforating. He went to surgery right away and did very well. An a-cell implant was placed (pig bladder tissue) and a conjunctival graft was sewn to his cornea. He has been a trooper. In order to treat him 4 times a day he came to school with me every day. He purred from his cage and let ophtho examine him without a fuss. He will likely need a second procedure to prevent the other eye from perforating, but we would like this eye to heal.
In an ode to Garfield, this poor cat has a heart murmur with a possibility of developing hypertrophic cardiomyopathy, FLUTD with a history of blocking, herpes, and now this serious ocular condition. He is quite the trooper and special guy though. I am so proud of him and how well he is done. He doesn't even mind his e-collar.
Ophtho went well. I do not want to be an ophthalmologist, but I really enjoyed learning about eyes and seeing some successful cases.
Thursday, September 16, 2010
Today I watched a cataract surgery and a surgery for a melting corneal fungal ulcer in a horse. That was pretty neat. Horses are less scary when they are asleep and he recovered really well. We put a graft over the defect, which was also neat to watch.
I hope I get marginally better with eye exams over the next 2 weeks. Tomorrow we have a lot of recheck appointments, including a Boxer with an indolent ulcer. I doubt I will be a slit lamp expert anytime soon, but I will just keep on trying. The eye is very complex and interesting, and challenging.
Wednesday, September 8, 2010
The slower pace of the service has helped me enjoy the block, and I have not taken that for granted. I have fit many nap times into my schedule somehow, and last weekend I had most of the weekend completely off. That left me time to sleep in on Sunday, canoe the New River, and play with my fabulous pup.
My next 3 week romp will be with ophthamology and the amazing Dr. Pickett. I am excited for that busy service as well. I certainly started enjoying 4th year in the VTH this block and I hope my enjoyment continues. The NAVLE exam is 2 months away and I need to start spending more time studying on the weekends. Speaking of which it is time to get started with an evening session...
Tuesday, August 31, 2010
My first week of orthopedic surgery was organized, fun, and a success. I had my first favorite patient, a well-behaved sweet sheltie with a rheumatoid polyarthropathy that needed a bone plate removal. We removed a bone plate that was infected, and the owners were the nicest people. I also repaired a calcaneal fracture on a cat, and even got to drive the IM pin.
Week 2 has started off a little rougher however. Monday we had a very slow caseload, and I was tired from attempting a 5:30 am crossfit class. We were released early and I took a nap, studied for boards and rounds and still went to bed at 9:30. Today I admitted my one patient for a cranial cruciate partial tear (expected), and took on a GDV on emergency (unexpected). Sadly, she was euthanized on the table. I practiced suturing her up by myself and returned her to her owner.
After surgery I was hypoglycemic, tired, and disappointed. Ortho was not suppose to be a sad block and I was expecting a better outcome, despite that GDV is often life compromising. I was so excited to see a surgery, I asked for the case. Afterward, I thought to myself why on earth did I want that case? I enjoyed learning about how to proceed with this surgery and emergency care beyond just passing the stomach tube which I have done in the past. I just could use some more happy outcomes than sad outcomes these days. I am beginning to think I am bad luck in cases with a poor likelihood of recovery.
I truly hope there will be many better days with better outcomes. I may defer treating future dogs named Maggie for a while. I am 0 for 2 in just 2 weeks.
I hope tomorrow has a better ending. Joys of 4th year continue...
Thursday, August 12, 2010
On Tuesday, we admitted a lab for a clinical treatment trial for a brain tumor. The procedure went very well and his recovery from anesthesia went well at first. Two hours after waking up, he had a seizure which we caught early. The second seizure did not respond to valium and we put him on a CRI of propoflo. After 6 hours we took him off the propoflo and he did fine, but 30 minutes later he went into cardiac arrest and died. He died of aspiration pneumonia caused by delayed gastric emptying. It was such a shame to see a dog with a brain tumor die of aspiration pneumonia. The reality of how common this occurs as a complication to anesthetic procedures hit me hard. I really held out hope that he would make a great recovery and live out some time with a shrunken brain tumor. Before the necropsy, I also wasn't sure if it was our fault for not intubating him while he was on the CRI of propoflo. Around 7 pm his heart rate picked up, blood pressure spiked, and his oxygen saturation was low. I knew something was wrong, but the doctors elected that he was okay. I now know it couldn't have been prevented or alleviated. He had a full stomach, but hadn't eaten in 12 hours before surgery, so something else was going on. He was an amazing dog with a dedicated owner and the story was tragic for me.
Besides being exhausted from 13 hour days, I was questioning how I would get through this year on lack of sleep and so much mental stimulation. For the millionth time in vet school, I was wondering "can I do this?"
Of course the latter half of this week our neurology service caseload has slowed down, perhaps someone looking out for me or just pure luck. I appreciate that I had time to process my feelings and get rest. I am terrfiied of surgery next block though, when a day off will cease to exist.
My mid-block evaluation went well. I need to "own" my cases more, and be more independent of the clinician, which has come a long way since last Monday, but has a long way to go. I have no clue how I will be ready to be a DVM in just 9 months. Time to take things just 1 day at a time again.
Sunday, August 8, 2010
I was humbled by how difficult it was to take an accurate history. I was also so nervous meeting clients and trying to do a complete physical exam in front of them. I missed tons of things, most that were obvious, like the patient was dehydrated. I had major confidence issues that I haven't had since high school and it showed to my clinicians. Most importantly, I have no idea how I will pass boards or be a doctor in less than 3 months and a year, respectively.
On a positive note, my first discharge and SOAP's were pretty good and by the end of the week things were turning around. My shifts in ICU went well since my main exprience was working as an emergency technician. I also really enjoyed following up with clients on the phone.
What makes 4th year so hard is that you are part student, part technician, and part doctor (or trying to be). Who has time to wear that many hats and sleep? It's also hard because your best friends may not be around for the support they provided the 3 years before. This weekend I remembered why my vet school friends are so amazing.
I miss having a life, but I got some reprieve with the terrific Steppin' Out Festival in town with friends Friday and Saturday night and a lazy Sunday with Matt and our dog. It's been 1 year since I brought her home from Washington and she now listens off leash. She is a great compliment to our family.
The hours are long again. I had an 18 hour welcome back Monday and 12 hour days except for Friday. The best part is you're suppose to read for rounds and study for boards on top of that! The truth is compared to surgery, that isn't even as bad as it will get. Finding time and energy to work out or eat was difficult. I will just do my best and take it one day at a time. I will also enjoy neurology since next block is surgery and having a life and sleeping will be harder to do.
Thursday, July 29, 2010
The Rally was fun and the weather, thankfully, was not too hot. Wayne spoke first and got the crowd pumped up. Wendi Mallick, from the TV show "Hot in Cleveland" spoke out on the ROAM Act. The ROAM Act (Restore Our American Mustangs) looks to end round-ups and slaughter of wild horses and burros, by implementing a immunocontraception program.
The Rally concluded with Rep. Jim Moran. I was told beforehand that he is a staunch supporter of our issues, but sometimes goes off on odd tangents during his speeches. This speech was no exception. Toward the end of his speech he started to bash the NRA, which is okay with me and funny, but seemed a little inappropriate.
I missed photo ops with Wendi to rush off to my 1 pm meeting with a staffer from my Rep. Boucher's office. She was very nice and I thanked him for being a co-sponsor on the PUPS Act, and voting in favor of many of our issues. She told me that Boucher heard from his constituents that they were upset about puppy mills and he listened. "All it takes is a few calls from his constituents and he listens and acts, she informed me." I mentioned the upcoming Truth in Fur Labeling House vote (which passed yesterday!), and started awareness on the Prevention of Equine Cruelty Act. As many people are, the staffer was outraged that some of her faux fur, is quite possibly real fur. Thank goodness for consumer protection loopholes.
After my last meeting, I walked back to our home base in Russell 385 and felt a slight let down that it was all over for the day. I really enjoyed meeting with the offices and felt for the first time what democracy can feel like. To be able to make an appointment and walk into my senators or congressman's office and voice my opinion was amazing. It would never happen in China.
Tuesday, July 27, 2010
Many other organizations were represented on each panel in the many different workshops, including Farm Sanctuary, Animal Welfare Institute, among others.
The all vegan menu was surprisingly delicious and included a vegan rendition of chicken cordon bleu and chocolate mousse.
Working at the registration booth Friday night reminded me of working retail during my college days, but it was fun. I ran into a girl, Nicole, who was on my RAVS trip last summer. She won the award for HSVMA student of the year. She created a student chapter of HSVMA and helped to end terminal surgeries at her vet school. Her work inspired me to try to form a HSVMA Chapter at my vet school before I leave.
While working the government affairs table, I discovered a new side of myself. I was energized by the many interested citizen lobbyists, and those that may not have been interested in our lobby day bills I actively chose to engage. I urged people that could not attend lobby day to cal or write their senators and representative. I learned that 1 personal call or letter statistically represents 10,000 people with the same interest. So 1 call really does matter!
In another outgoing moment, I spoke to Nigel Barker and asked for a photo op. His work as a celebrity spokesperson, filmmaker and photographer has helped to end baby seal hunting in Canada.
The banquet was great. Congressmen Rahall from WV gave a great speech and we commended him for passing 11 wildlife bills through his committee during 2010. Hal Sparks was hilarious and I laughed harder than I had in a very long time. Wayne's speech was passionate and serious, but was interrupted by Spanish music in the adjacent ballroom. All the speeches made me question my own choices and made me wish our country was more in line with change. Wayne argues that the American public is ready, but government and interest groups are slowing the change process.
While the conference was exhausting on many levels, I am not only glad I was able to attend but that I was able to represent the Humane Society. And once again during the last 6 weeks, I feel invigorating and passionate for my career and all the many directions I can take.
Thursday, July 15, 2010
So for the reasons above, among many others, I am proud and privileged to be an American. Yesterday, however, I was frustrated to be an American. Despite wealth and intelligence, important and pressing issues may not advance and I am baffled as to why.
I attended the 3rd of 3 hearings concerning antibiotic resistance. Coincidentally, during my animals and public policy course last year I presented a paper on the urgency and precedence this issue must take in order to keep our antibiotics working for animal and human health. There were so many frustrations I do not exactly know where to start, so I will list them out:
- 3 Republican Representatives slammed the Obama Administration's health care reform bill (not the issue to be discussed) then left the room.
- 1 Representative discussed his own agenda with an expert witness from the FDA-Center for Veterinary Medicine regarding FDA jurisdiction over the illegal importation of counterfeit pharmaceutical drugs. He left the room after his time was finished.
- Despite a co-Chairman of this subcommittee, who was present at the meeting, raising the identical question of "Can antibiotic resistance in animals be passed to be people?" in 1980, there was debate over there has been enough peer-reviewed scientific evidence to enable Congress to act on this topic. 30 years have gone by and we are in the same place, only with more antibiotic resistance in humans and people.
- The argument was made that low-doses of tetracyclines in food animals increases their health without creating resistant organisms. What does vet school teach you in clinical pharmacology- low doses of any antibiotic in any living animal creates only resistance.
- One Representative stated, "Animal and human health are like apples and oranges." This statement had me enraged. How uneducated can you be. Animals carry the food-borne diseases that make us sick. In addition, if you want to use an ignorant analogy like that, a smarter way would be to say, " Animal and human health are like a granny smith and a red delicious apple."
- The representative for the AVMA stated there is not enough evidence to either prove or disprove that antibiotic resistance in animals is transferred to humans. Directly to her left was a veterinarian who works for the AVMA, who stated that in her professional experience she has seen many accounts that animal diseases with resistant strains of campylobacter have created human outbreaks of campylobacter that then did not respond to traditional antibiotic therapies. By the way, she also had a 3 inch binder of epidemioloigc studies.
- When asked the question, "Is there any scientific debate that antibiotic resistance in animals is transferred to humans?," the chief veterinary officer of CDC, the head of USDA-APHIS, and the head veterinarian for FDA all answered "No there is not."
- "World Health organization studies are irrelevant to American data."
I left very frustrated and frightened for the future. After 30 years, we still debate what 3 experts declare is not debatable instead of moving forward to protect an important class of drugs. I personally believe our government is too large and parties too divided with too many self-serving interests groups with money controlling the power or re-election to function properly.
I hope my next days on the Hill are a little more promising..and relevant.
Monday, July 12, 2010
My ultrasound work and anesthesia presentations went very well. The panda base definitely wants more vet students in the future and found it very helpful. I watched Luoli get much more comfortable with ultrasound, and she said she would continue ultrasounding the one pregnant panda we started working with.
The director of the panda base saw me off with a wonderful dinner of Chengdu tradition of hot pot. My flavor tolerance for spicy food increased like everyone told me and I impressed myself and my hosts with the amount of spicy food I could eat and enjoy.
I got to visit the Moon bear rescue center outside Chengdu. This is a reserve for bears involved in the medicinal bear bile trade. Bear farms are legal in China, but are slowly closing with the help of Animals for Asia. The treatment of these animals is appalling. They have permanent catheters or fistulas in their livers to collect bile. Most of them are cage-ridden for life and develop liver cancer and skin sores. Some bears develop worse medical conditions. Animals for Asia (www.animalsasia.org) works with the Chinese government to shut down one farm at a time. China feels they cannot outlaw all of them at once because of the financial ruin it would cause to the farm owners.
I was disappointed that this isn't really exposed to the American public and hope that I can increase awareness to have this animal mistreatment stopped. The bear center is amazing. These bears have unlimited enrichment and medical care to live out the rest of their lives peacefully.
There is so much more I could write about, but I have to re-adjust to life as an American, which I appreciate more than ever. In summary, my 3 weeks in China were as life-changing as I hoped they would be. Being there fueled my passion to practice international veterinary medicine in the future. The East will need the help of Western-trained vets in species conservation and fighting zoonotic diseases.
I was blessed with the opportunity to create life long friendships on the other side of the world. Because I couldn't travel around the country, I am excited to go back to see more of Asia and China and to continue working as veterinarian in the future.
Thursday, July 1, 2010
I think things have been going pretty well. There is some down time, as the previous student here had told me, but that was to be expected. I have been working mainly with Lou Li, a Chinese vet, ultrasounding 1-3 pandas per day. In the non-pregnant pandas I am able to find the uterus, bladder, colon pretty easily. We were allowed to work on 1 pregnant panda and it hasn’t been as successful. They do not want to use alcohol because the pandas lick it, and this panda scratches the gel on as soon as you apply it. I also messed up yesterday by not cleaning her fur that we shaved off very well, so then it was getting stuck in the gel. Besides all of those issues, which are normal when working with animals, I can locate her bladder, but seem to be lost looking for other structures, which could be because she is pregnant. Lou Li is not mad at all and we will try again today.
We were talking about my last week and Lou Li seemed a little sad and asked if more of us will come. I said this is a trial program of what we hope to be a yearly exchange if it was helpful to you. She quickly and emphatically made it clear that she has enjoyed having us and hopes other students will come, so that was certainly a good sign. Mr. Wang Cheng Dung had attended 2 ultrasounds and seems a little frustrated to see the distinct outlines of each structure on ultrasound, which is not always possible, but I try. We all decided that I should give a presentation with our saved ultrasound images labeling the different structures, but the memory card doesn’t seem to fit in any of our computers, so we’ll see what happens with that.
There are 2 other Americans at the base, one is Chinese –American and it has been a blast to be with her. She and her family friend took me out last night for street food on Jin-Li and it was very fun. It felt good to be a tourist with locals who speak the language, and eat some pretty darn good albeit weird Chinese food.
Last night, on the panda base, and part of the time I was in Emei Shan are the few times I have felt comfortable being a foreigner or “lao wai.” I had been told it was derogatory by Americans. In the taxi last night I heard my friend say lao wai and the taxi driver say it. My Chinese friend kept saying, Chinese people like foreigners. This was conflicting since I hear “ lao wai” everywhere I walk. There is some interesting debate on this word (see http://en.wikipedia.org/wiki/Laowai), but my friend and the courtesy they showed me last night proved to me that it cannot be derogatory unconditionally.
As my last week in China approaches, I am both a little remorseful and a little home sick. I am craving a sandwich like none other, but have been truly happy working outside of my comfort zone. I am also very proud of myself for coming here and handling many of the adventures China has provided to me. I really have only had 1 rough day so far, not to shabby.
This weekend I am going to an ex-patriot restaurant to see how Westerners hang out in Chengdu, a Buddhist organic farm, and some more tourist temples, tea and shopping on Sunday. I toyed with the idea of seeing some blue-sky China, but figured I should see some of the fun aspects of Chengdu before I go. As I keep reminding my travel-loving self, this is a trip for veterinary and cultural experience. If I want to more extensively travel, I have to come back. It is comforting to know, I now have a good Chinese friend to travel with if the next opportunity crosses my path in the future.
Monday, June 28, 2010
While I feel very homesick this morning, I have to report that my first week in China was a success on many levels. First and most importantly, I have learned to adapt to being outside my comfort zone. I also proved to myself that mental preparation is invaluable in surviving outside of the comfort zone. I have learned a lot already about Chinese culture, veterinary medicine, and how they value their animals, especially the giant pandas. The language barrier is a little harsher than I had hoped, but by the end of last week I think I befriended a few Chinese veterinarians at the base. The funniest thing is if Chinese people don’t speak English they just keep talking to you in Chinese as if you will somehow understand.
A list of Chinese habits that are outside my Westernized comfort zone:
o Spitting inside buses and buildings
o Amusement at animal taunting
o Lack of overall bathroom hygiene- the closer they come the louder they yell
o Eastern squat toilets and no toilet paper
o Rivers of raw sewage running through town
o Honking constantly
o Driving on any side of the road
o Lack of English in well- touristed areas
o Minimal veterinary medical training and understanding of physiology, anesthesia, and antibiotic use
o Whole pig carcasses carried by scooter
…to mention a few
My adventure to Emeishan was most certainly an adventure. It included hooking up with an Irish couple backpacking through Asia, staying in a monastery, numerous and sometimes scary macaque encounters, many sets of stairs, and discovering I do not like to travel alone. I am very glad I decided to travel there this weekend. It was a little more exuberant and adventurous than I bargained for at times, but in retrospect it was one of the cooler things I have done in my life. At no point other than a stand off with a nasty macaque out for human food, did I feel unsafe. For anyone thinking of braving travel in China alone, however, speaking the language even just a little bit can go a very long way to enjoying yourself more.
This week at the panda base will involve more ultrasound, possibly on the pregnant pandas and ivermectin treatments. I am also working on presentations on anesthetic monitoring and the importance of a manual CBC. There is a training for the zoo staff in Macau this week because they will be getting 2 pandas, so it will be a busy week at the base.
Thursday, June 24, 2010
Ni hao from Chengdu. After a very long 20+ hours of travel I arrived at the apartment in North Chengdu, Sichuan Province. The next day was a little rough in terms of jet lag, in fact I didn’t sleep well my first 2 nights which reminded me of Lost in Translation. I struggled through the jet lag and got lunch and some groceries. A little RMB goes a long way here in China. People are nicer than I thought they would be. They also stare at foreigners. The children are funny, they stare and giggle and say hello in English. The bicyclists and mopeds try to run you over and crossing the street is pretty much like playing frogger. The first few days I walked out of the apartment smiling. Being in China is certainly a novelty to me, and while communication can be difficult, it has been fun.
I am proud of myself. I definitely mentally prepared to be outside of my comfort zone. I miss paper towels and cheese, but am doing okay for the most part in terms of culture shock.
The panda base is outside the city and is in a pretty setting. It is essentially like a giant and red panda zoo. The red panda exhibits are very crowded. They are nicknamed lesser pandas by the Chinese, but I think they are exquisite creatures. Many of them have tail injuries from fights and stress behaviors. The giant pandas are truly amazing creatures, appearing gentle and playful. The Chinese covet the giant panda, but the respect for animals, while changing is not on the same level as it is in America. The best way to explain this is to understand that training to be a veterinarian is simply like majoring in vet med in college. They only go to post-high school for 4 years to be a vet and many basic physiology and pharmacology concepts are missed. So while I am here to help with ultrasound, which I have been doing a lot of, I can help in many other little ways.
I help with translating documents for the panda base visitors. I started explaining to them the importance of looking at a blood smear, instead of just relying on the machine’s numbers. I plan to give a presentation on the importance of anesthetic monitoring. I will help research articles for reproductive topics they are interested in. I have been showing them how to use some of their machines, including the ultrasound.
I am by no means an ultrasound expert, but there are some basic principles I can teach them. I am very happy to be here and I hope at the end of 3 weeks they are happy to have had me here as well. I have to say being so close to the pandas is very fun and ultrasounding them is also fun. Many of the pandas have been trained to lie on their backs for us, it has been very impressive.
Every day has been an adventure and so far I am so glad I decided to take the risk and come here.
This weekend I will take a trip to Emeishan a UNESCO world heritage site and holy buddist mountain. I am going alone, but hope to find some English speakers at a Western-friendly hostel when I get into the town. Sarah, an American who works in the conservation education office at the panda base is taking me to the bus station, and then I hope it’s as tourist friendly as the guide books say it is. I will have my Chinese-English dictionary just in case.
Here’s to a great week 1 in China and hopefully a fun weekend trip.
Wednesday, June 16, 2010
The other bittersweet reason is that I am going to miss the Blacksburg community. I will miss my yoga class, Crossfit, the summer solstice festival this weekend, among other fun things. I also worry about learning the real hospital paperwork during block 5, after most people have learned what's going on and how to write SOAPs, and who gets what copy of the numerous forms we are forced to complete in a state-run teaching hospital.
On the other hand, I am very excited to experience a new country, practice ultrasound, and work with the amazing giant and red pandas. This experience was one of my dreams when I first applied to vet school, so the reality of it coming t fruition is very exciting.
I am suppose to have internet access in China, so I hope to post pictures and blog posts with how it is going.
Until then, to a safe flight, safe drive back to DC, and success on my radiology interpretive exam!
Sunday, June 6, 2010
My 5th wedding anniversary was fun. An exotic vacation would have been nice, but we had a wonderful all-local dinner at the Bank is Pearisburg Friday evening. Saturday we got a late start but headed out for some day hikes on the Blue Ridge Parkway. Ironically, we got lost on our first stop to an elusive Nature Conservancy waterfall hike and got directions at Amhrein winery, which was my original anniversary date plan, but they had no events going on that day. The hike freaked me out for some reason, and we left. We climbed the Peaks of Otter and had a great time and great views from the top. We stopped for dinner at Thelma's Chicken and Waffles, which was delicious and then wearily wandered back home.
Sunday was just another Sunday like the past 3 years. Grocery, study for test, lay with dog, laundry, etc. I do not miss those days. Luckily only 1 other block has exams. Next year, however, 4th years could be taking an exam after each block. I do not envy them.
Monday, May 31, 2010
The block started off bumpy and ended smoothly. I wish I had seen more medicine cases, but that is the luck of the draw. I still had a good time doing herd health and reproductive medicine with some pretty amazing farmers in some pretty nice facilities. I truly wish I had had some clinical experience with production management sooner because I may have consider being a mixed animal tracker. While I did not always like learning about production animal medicine, doing it was much more fun than I would have imagined. The clinicians made it fun as well.
The block ended with a Memorial Day weekend cookout at Dr. Schramm's new abode, complete with a relaxing dip in a hot tub and a locally grown steak for the husband. It doesn't get much more American than that.
Next block is radiology, also known as radiation vacation. I hope to learn a lot and significantly improve in my radiographic interpretation skills. I will also be sneaking in to get some ultrasound experience if possible.
Here's to block 2!
Monday, May 24, 2010
Since Lost was with me before vet school and during vet school I thought it apropos to address the series finale in relation to my life as a vet student. Over the past few years, I have struggled with the concept of relationships throughout life. More specifically, it is difficult for me to let close relationships fade or die. My sister and others have indicated that life is full of relationships. Many of them are very important to shaping who you are as a person and/or helping you through a crisis or situation. Unfortunately, most relationships are temporary; some are shorter than we'd like them to be, while others may last a lifetime.
Crazy as it may seem, this episode of Lost may not have answered all of my Lost questions, but it reminded me of a more important concept. This reminder could not have come at a better time. As I begin my final year in vet school, some of my close friends have started graduating and moving on. It has been difficult for me. The long distance relationship with Matt and now my dog has also started bothering me again. The series finale of Lost reminded me to allow relationships to change and end...to let go as I have to. The bright side is to try to remember all of those people who had an impact on who I am, who I have become and who I will become. It is okay to let go. It does not mean anything is wrong with me if relationships fail, it is just a part of life.
Remember and let go.
Another veterinary lesson I have recently experienced is that some times we try to make animals feel better, yet we make them worse. This very sweet Jersey cow (#4453) at the VT dairy had severe diarrhea due to to indigestion. We decided to drench her, but Jersey's hate to be drenched. While my partner and I thought she was swallowing, she ended up spitting out and aspirating most of the drench. We cured her diarrhea, but gave her aspiration pneumonia. Luckily, I saw her today and she is doing much better. I felt solely responsible for making her very ill. I was assured by several DVM's that Jersey's do this, and it's not my fault. Well, it sure felt like my fault. This will happen time and again. While we do our best to make animals better, we will fail. Like Jack Shepard learned we cannot fix everything and sometimes we make it worse unintentionally. Remember, forgive and let go.
In summary, Lost fans do not dwell on what was not revealed over 6 seasons. Take away life lessons and just let it go.
Wednesday, May 19, 2010
I performed my first skin biopsy, have gotten pretty good at hitting the bovine jugular vein, and know a lot about cattle feet and reproduction. It truly is some hard work.
Today, I put in my first set of ear tags and worked the chute catch for the first time. It was a little bumpy, but I made it through. I also palpated my first fetus today, which was very exciting.
In my spare time, I have learned more about my upcoming trip to China and I am resetting my expectations - more on this in another entry to come.
I got to spend my birthday evening with 9 great friends at a fun Mexican restaurant. The margaritas, however, made me ill and as I was finally falling asleep last night some new neighbors underneath my apartment decided 12:30 am was an excellent time to hang pictures on their walls. I had to half asleep remind them of the time. Oh well, there are far worse birthday endings to a great day than that. Being tired is just part of 4th year anyway.
Sunday, May 16, 2010
Of course the 1 week break was also not as restful as I needed it to be. The townhouse was a construction site, and everyday was packed. One day I did have a wonderful facial, massage and dental cleaning. I drove back to Blacksburg on Mother's Day with my 3 cats, but without Miss Spokane.
In just 1 week of 4th year, I missed her terribly. The reality of why she canot be here, however proved to be true. I had 2 mornings when I had to be up between 4:45 am and 5 am and 1 overnight stay in Jarratt, VA.
The first 2 days of PMM (Farm management) were a little rough around the edges. I was bruised by mishandling of beef cattle in the chute, tired, and covered in poop each day. Wednesday through Friday were a little more fun. We received a pet goat in renal failure who we got to treat more like a companion animal than a production animal. The trip to Jarratt to breed cows via artificial insemination was actually very fun. I learned to thaw semen, and we drove a pick up truck to closely look at the different herds. We rated their body condition and overall health. I also met an adorable bottle-fed calf named Phyllis who will need a home eventually, as she is not "beef material."
On Friday I was on ambulatory with Dr. Becvar. We spent the day hoof trimming at a pretty dairy farm in Dublin, VA. It was hard work, but we were well rewarded with a scenic drive and chocolate milkshakes.
This week I face another overnight trip and some quality time with sheep and the infamous Dr. Pelzer. I think I will get more sleep than last week and compared to some classmates in other rotations, I may just have a great block to start 4th year.
A few close friends graduated this weekend, and as usual I am emotional. I love my community here and it was a glimpse at how hard it will be to leave Blacksburg and say goodbye to a difficult, albeit fun chapter.
Sunday, May 2, 2010
Saturday I completed the Helen challenge at Crossfit for a charity called NRV Cares with a vet school friend (who kicked my butt and won a free 1 month membership). Then Matt and I joined 2 of our friends for the wine festival. We soaked up the sun and some refreshing wines. After that we headed to Roanoke with a different amazing couple for superb Mexican, martinis, and the best jazz concert ever featuring Brad Mehldau and Joshua Redman. It was absolutely amazing.
While I need to relax, I also need to be around people that appreciate me for who I am and so far it has been amazing to spend time with great friends. Luckily it's only beginning, as my week of freedom ends by seeing my best friend and my nephew in Boston. As a classmate of mine likes to say, "What could be better?"
Saturday, May 1, 2010
I am starting to get a little scared of 4th year, but I know it will be fun once we know what we're doing. My first rotation is PMM production management. It will be farm calls, not my finest subject. I just have to show up with a good attitude, hope I don't get cryptococcus, or stung by a wasp nest in the chute poles and all will be okay I hope.
Today is a jam packed day of fun, not sure if I have the energy for it, but here goes nothing. Charity workout at cross fit called Helen, which is 3 rounds of
21 Kettle Bell Swings
Then a quick shower before the Fork and Cork Blacksburg wine and food festival. Followed up by Alejandro's in Roanoke for dinner and a Brad Mehldau and Joshua Redman jazz concert.
Whew, tomorrow will be a day of rest and organizing my notes for PMM. Fun times.
Sunday, April 25, 2010
being terrified of the pharmacology midterm and crying from being overwhelmed just before the lab where we learn how to get cows in a chute.
everyone telling me how fast it will go and thinking to myself, "but each day is so long."
jumping out of my seat after 8 hours of lecture to run on the indoor track and clear my head.
studying in the library bridge for 10+ hours straight including meals and vowing to never do that again.
walking up the steps after a long day and anatomy lab, thinking to myself, "what the hell did I do? I left this easy job that paid well, for this stressful, formaldehyde-smelling life that doesn't include Matt."
some point in the middle of 2nd year no longer questioning why I left my finance career behind.
my surgery partner (also a second career student) saying "isn't this so much cooler than sitting at a desk all day?" as I finish closing up my canine castration incision.
thinking I am not smart enough to be here.
all those nights I could not fall asleep despite melatonin, benadryl, excedrin pm...
the feeling of what do I do now after the last final of each semester.
and I am sure to remember so much more over the next year, hopefully those memories will be just a little more positive than the first 2 years.
Friday, April 23, 2010
Everyone asks, "Are you ready?" No, who is and who will be? I am ready to stop sitting on my bum all day watching powerpoints. This time next year I won't be ready to become a doctor, but I'll do it and it will be okay in the end...because if it's not okay, it's not the end yet.
I think the important thing to remember is that there is a steep learning curve. I need to be patient with that learning curve and work at it slowly, day by day, just like the past 3 years. I assume in retrospect, also like the past 3 years, it won't seem so horrible. In Tao they talk about water as being the strongest element of life, not because it is the most forceful but because it is determined and perseveres over time to shape rocks and mountains.
In my opinion, that Tao quote would be the best way to sum up the first 3 years of vet school. And when I have a horrible day on clinics, I must channel what would water do, it would just keep flowing.
Monday, April 19, 2010
As promised, here is my story about taking Spokane to the vet a few weeks ago:
Spokane was lethargic and not acting right for a few days. She vomited twice and was having some intermittent diarrhea. I had faith that it was simple dietary indiscretion and withheld one of her meals and gave her half of her dinner that evening. The next day she had a mild fever of 103 and didn't want her breakfast at all. I started to worry it could be a systemic infection and thought I should take her in.
First of all, the vet tells me it may not be a real fever, she may just be hot. I explained that I took it twice after she was calm and inside and it's real. He believed the diagnosis to be dietary indiscretion, but worthy of a fecal. He quizzed me on the most obscure parasite on the fecal, which I learned as Giardia, but he said was whipworms. Spokane is on a heartworm preventative that kills whips, and while of course it is possible she could have them, it is less likely the culprit.
The fecal was normal and he thought she was acting fine. I clearly wanted him to do something else since it had been 4 days of lethargy and she was now showing systemic signs. He came back in the room, told me she should be on a dog food for a bigger, more active dog instead of a food for her current weight (she is not underweight) and then offered a subcutaneous injection of penicillin G to "reset her GI flora." He indicated that sometimes this helps get them back on track.
Dr. Leib never mentioned resetting GI flora with penicillin and I was pretty sure that wouldn't kill the possible bacteria that could be causing the problem. He also claimed that dietary indiscretion was just a nice word for food poisoning, which I also didn't recall from GI class.
I went ahead with the shot. I thought to myself, "he thinks it works because in the past the client was happy that the doctor gave them something, but their animal would have gotten better anyway. And of course the next morning Miss Spokane was back to her old crazy self, but no thanks to penicillin G.
Since we have talked a lot about antibiotic usage in clinical pharmacology, I decided to speak to my professor about it. I learned that not only is using penicillin or any antibiotic one time only to reset GI flora not true or useful (you would want the normal flora present to compete with the real "bug"), but a subcutaneous dose would not even reach her GI tract in the first place. We started cracking up. Another professor was there and said that at least I recognized that she was better because she would have improved anyway, not thanks to the good old pen G.
It is hard to be a vet and a pet owner. I understand why the vet did what he did, but he also created more antibiotic resistance and stuck a needle in my needle-averse dog (she takes after her mom). Clients often want a fast fix when there isn't one, but many vets give one anyway if it's not too harmful. It was also hard for me to withold food for the more appropriate 24-48 hours, which would reset the flora, because I was worried (like most owners) that she would be hungry. I also use whether an animal will eat as a sure sign they are feeling better.
It was quite the learning experience. I will face many challenges as vet and these some of the most common are client happiness and compliance. I am glad I recognize the situation as a learning experience and I will be reflecting on how I as a new vet can balance these issues to provide the best care for the animal in the most responsibly way.
Sunday, April 18, 2010
Here is hoping I make it to 4th year and a better blog post is to follow.
Sunday, April 11, 2010
This semester started flying by recently with only 18 more days left of 3rd year. I have only 4 more exams and paper standing between me and 4th year now. While these first 2 exams will be rough, I have found my favorite study location once again this weekend. I have faith that it and 7 more days of perseverance will get me through. As tough as this next week is, it really is not as tough as some other vet school weeks have been in the past. Is this because I have been through the trenches before, an finally after doing it so many times know there is a light at the end of the tunnel? Or is it that 3rd year just isn't as rough around the edges as second year?
Despite all of the hard work ahead and confusion of whether I am smart enough or remember enough to be a 4th year, I have been enjoying the beautiful weather with Matt and our dog. She has really turned a corner in terms of maturity and our bond is growing each day. She truly is amazing...when she listens.
I have quite the funny vet experience to share on my next entry. This time I was the paying customer and the vet did everything they tell us not to do in school, yet I understood why he did it.
Stay tuned and I'll return with the anecdote when I dig myself out of the trenches in just over a week.
Saturday, April 3, 2010
When I think back to first year, it feels like a long long time ago, yet it went by very fast. I remember thinking, will I really wear a blue jacket and be a 4th year? It seemed impossible, and in fact the next few weeks will be tough, but I can almost count on 1 hand how many more exams I have to endure until I start clinics. That is crazy. I am excited and ready. I am not excited for giving up my free time, especially as I grow to love the New River Valley more each day, as I experience it with Spokane.
The past 2 weekends have been amazing. Last weekend I placed 3rd in my age group in a 5.25 mile trail race and had the time of my life running it. This weekend Matt, Spokane and I had a great day blazing new hiking trails and trying an amazing local restaurant. I am glad I have made every effort to make Blacksburg my home and to embrace it, as opposed to allowing vet school to gobble me whole.
Life has hit us with some stumbling blocks these past few years, but suddenly I feel as if things are changing in a positive way. Not that anything was ever horrible, but perhaps we are learning to make lemonade out of lemons. Simple to say, much harder to practice. Am I finally learning how to be patient and slowly work toward an important goal? I certainly hope I can continue learning how to adapt, I think it will benefit me for the next 12 months.
On another note, I am starting to feel as if vet school has changed me since I started only 2 and half years ago. I can't put my finger on how I have changed, but I definitely feel like I am growing and changing. I felt this way before when I changed between 21 and 23 and again between 25 and 26. It's a strange feeling that may be coming because a transition is just over a month away, but nonetheless recently something feels different than it did 2 and half years ago. When I can identify what that difference is I will be happy to share it.
Sunday, March 14, 2010
Spring break was hectic and a bit of a calamity, but fun nonetheless. I am glad Matt pushed us to go to Jackson Hole. It was beautiful, with relatively warm temperatures and great to get back in touch with nature. Skiing was an absolute thrill for me. After 1 full day lesson, I was back to a beginner-intermediate level after a rough start in the morning (my nerves were taking over). I fell in love with skiing all over again and really hope I can go more than once every 8 years. Matt on the other hand tried snowboarding, which I thought was safer than his nostalgic skateboarding. I was proven wrong. Poor guy was doing great, until he fell and fractured both wrists. My plan was for him to love snowboarding so we could go ski/snowboard at least once a year. It sort of backfired. He may try again, he may not. Word of advice: Wear wrist guards until you learn how to fall properly.
I saw some family and friends, didn't get enough work done, and managed to get a fair amount of sleep. We selected new floors for the house, and hopefully the construction will start shortly. I missed my pets very much, but they are all doing fine and I have 2 of 4 with me in Blacksburg this week.
I really needed to clean out the house and closets for charity and organizational purposes, which I had no time to do. While I want to go on a camping trip during my week off between 3rd and 4th years, I may have to sacrifice or come up with some plan to get the cleaning done with time to relax. I still owe myself a day of nothing but tv and relaxing.
Only 8 more weeks of 3rd year remain and less than 100 days until I leave for China. I am vaccinated and only missing a VISA and a plane ticket. Exams are spread out until the end of April. For now it's time to sit back, finish as strong as possible and enjoy my freedom of classes...never thought I would say that one, but also never thought I'd actually wear a blue jacket.
Sunday, February 28, 2010
I also organized my last Pfizer event as a student representative. Somehow I pulled off a spectacular pain management wetlab Friday evening. Everyone who attended seems to have greatly enjoyed the lab, and I was happy to have my last event be more than just another lunch time meeting. For those of you readers not in vet school yet, you will know what I mean soon enough.
I did a little more planning for my elective externship block in China. I received $1500 toward my trip from the school and purchased additional health and evacuation insurance. I plan to purchase my plane ticket over spring break and my VISA in early May.
All in all things are coming together. Matt and I picked out some new floors to repair the house that I absolutely love, and our trip to the Grand Tetons is one week away. I found someone to watch the pup while we are away and should get to some friends and family albeit briefly when we return to DC.
Here's hoping the hemolymphatic final exam goes as well as the midterm and I can pull off a passing grade for my pass fail advanced imaging elective, which I have not even started studying for just yet.
After spring break, we will only have 6 weeks of classes left. Exiting. More importantly I hope warmer weather awaits.
Thursday, February 18, 2010
I hope for winter to pass and a lovely spring to replace it. Spring break in 2 weeks off to the Grand Tetons. Hopefully it will be relaxing, fun and not too cold. In the meantime we have been challenged with sever water damage to the house due to ice and snow in our gutters, Spokane having no temperature too cold for her, and crossfit workouts.
As always I am keeping busy despite the wind trying to blow me over.
Sunday, January 31, 2010
I have not written about this semester yet, because I have been confused and unexcited. My patience for powerpoint presentations, tests, and immature/unprofessional classmates coupled with 1 day a week in the clinic has made me yearn for the clinic more than ever. Yes it is scary and yes I know I do not know everything, but I am ready to stop learning by memorizing and start learning by doing. My motivation this semester has waned. I have had moments this semester when I am studying and going through the motions I have done so many times before and I feel like a parody of myself; highlighting, underlining, writing out notes and charts. I have done this all before for 2.5 years and I am ready for a change. I suppose the novelty of vet school and learning all you can learn as fast as possible has worn off and I want to start learning how to put it all into practice and learn how to do the job I signed up to do. I am also over not living with my husband regularly. In fewer words I am done...but I am not. I have 13 more weeks of parodying myself in order to reach 4th year where we cooperate and graduate!
I have many exciting plans for 4th year, and as of this weekend for spring break. Matt and I will be exploring the Grand Tetons in Jackson Hole, WY. I am just ready to reach some of these exciting experiences.
I suppose I should just sit back and enjoy this semester. I dropped all but 1 elective because I wanted more free time. I should use it to work on my patience, my friendships and saying goodbye to the classroom, even if it is slower than I would like. There is no point in rushing my life away, even if something better is on the other side. As Dr. Rick Debowes of Veterinary Leadership Program says, choose happy. That is what I must do.
Friday, January 8, 2010
I can't honestly say my break was relaxing, but I did accomplish some important tasks. I worked 7 shifts, possibly for the last time as a technician at the Hope Center. I visited 4 other animal hospitals and have definitively decided to do a private practice small animal internship. I worked on funding requests for my externship to China this summer. My mom came to visit from NY and meet the granddog. I did some shopping, got a little sleep (not enough). I cleaned many bathrooms and vacuumed much pet hair. I also got in a little workout time (again, not enough). Consideringmy break is shorter than the rest of the school because I am a third year vet student, it was a veyr prolific break.
The most interesting turn of events, however, was the unexpected purchase of a new car. In our original plan, we had hoped Matt's 1997 Acura would last a year or two after I finish school. Never in our wildest dreams did we prepare for my 2006 Honda Accord to have transmission failure at the tender age of 6 years 80,000 miles. It was a shocker. The next thing I knew, we were sending my NY Yankee to the used car lot and trading it in for a 2010 Honda Insight Hybrid. I didn't have time to mourn, and we barely had time to triple check our decision. We knew of a minimum of $6,000 in repairs on my car alone in the next year and the x factor of additional repairs was very scary. I also was taught when the transmission goes, the car should go. C'est la vie.
The Insight is very fun to drive, easy to park, and more ecofriendly. It has many cute features, but some of the more luxury features of my old car are missing, such as the sun roof, seat warmers, steering wheel radio controls, 6 disc cd changer, powerful V6 engine...etc. I am still getting a little teary-eyed as I write this, but I was proud of our negotiation skills with the car salesman and deep down I know that everything happens for a reason.
I am very grateful I survived the trip back to DC, as apparently the car was very unsafe to drive.
Cheers to the last semester sitting in the classroom!