After medicine, I rotated through the special species department.  That is where all of the birds, reptiles, rodents, and rabbits go to be examined.  It is a department that runs differently than the other departments.  Since there is a chance that the patients can be quite dangerous (people have lost fingers to large parrots before), the students generally get a history from the owner, report back to the clinician, and then the clinician and the student do the physical exam together while the experienced technician does all of the restraining.  I got to do some interesting things like tube-feeding a bird.  I also got to draw blood from said bird.  I met a few nice rabbits and made friends with a lizard or two.  It was a nice, relaxing rotation.

That is in stark contrast to my current rotation, small animal surgery.  I’ve been putting in 12-14 hour days every day since Tuesday and it’s really wearing on me.  Mondays are elective surgery days and so last week, I did my first solo open castration on a 5 year old Rottweiler from an area rescue.  Everything went well and I’m glad I got the experience of doing an open vs. a closed procedure.  I’m trying to work up the courage to do a spay tomorrow.  I had such mixed experiences during my first surgeries in 3rd year that I’m rather gun-shy about surgery in general.  I know I just have to suck it up and go for it.  Surgeries like this are going to be expected of me in day practice.  The rest of the week, we see appointments and perform surgery as needed (except we go from being the surgeon on Monday to being the sterile suture-cutters the rest of the week).  The student on the case gets to scrub in on the procedure, but with the resident performing surgery, the clinician/faculty member assisting or observing, and the intern actually assisting, the student is lucky to be able to see the operating field.  Amazingly enough, we discharged all of our patients on Saturday, so no one had to come in for rounds today.  It was truly a gift to have one day away from the veterinary school this week!

Aside from school, I’ve been really focused on job-hunting.  The Captain just accepted a new job that will take us to a different state, so I’ve been focusing my job search in that area.  Luckily, being an airline pilot has its perks and we really can live just about anywhere his company flies.  That could bring us quite close to his immediate family, and I know that would make him really happy.  I just want to find a job.  The market is really scary right now and there aren’t a lot of postings for new vets with no experience (ie. just out of school like me).  I’m keeping my fingers crossed that it will all work out in the end.

I’ve been getting a lot of wedding things accomplished lately.  The days are ticking away and my countdown clock says that we have 118 day left. That is one thing that I truly cannot believe.  We have been waiting so long to get married and the time is finally almost here.  I can’t help but think that 2012 is really going to be the year that all of my goals are achieved at once.  I guess I’m going to have to make some new ones!  Oh yeah, paying back my student loans.  That’s a good goal.

I live with a low level of chronic back pain. I consider it a small price to pay considering that I would have been in a wheelchair if I had not had surgery. However, something went incredibly wrong over the past week or so and my low level of chronic pain started to get a bit more severe. The first insult, I think, came from when the Captain and I took our engagement pictures.

This is probably my favorite of the 40 pictures we took, but it forced me to bend backward in a way that my back is just not used to enduring. I finished out the week taking ibuprofen and things seemed fine. The second, and much more severe, insult came on Thursday when I was getting down on to the floor to insert a urinary catheter into a dog (no, I do not have a photo of that one!). All of a sudden, it felt as though someone were ripping the muscles in my back into tiny pieces. When the pain didn’t go away, I realized that I needed to go to the ER. My first fear was that something went wrong at my previous surgery site. The ER docs explained that I was having muscle spasms and they gave me all sorts of terrifying IV medications and sent me home with muscle relaxers and opioids.

By Friday night, the pain was back with a vengeance. I could barely walk around my apartment. After several phone calls, my mom told me to go back to the ER and that she was driving the 2 hours to be with me. At that visit, they took radiographs and gave me more scary IV medications. Long story short, there was nothing wrong with my spinal instrumentation (I was told that all the metal in my back would likely survive a nuclear blast). I have one narrowed disc space but that is to be expected with someone who has had my sort of surgery.

That brings me to where I am now. I’m sitting at home after missing yet another day of school taking my muscle relaxers and antiinflammatories like clockwork. I really hope that I can get back to school tomorrow, not just because if I miss any more days, I will have to repeat the rotation, but because I do not do well sitting at home. I just don’t know how to relax.

That brings my grand total of ER trips this year alone to 3 visits. That is more times than I’ve been to the ER in all of my previous years (once for milk aspiration when I was a baby, once for a broken arm when I was 4). I’m told that things like these come in 3s so I sure do hope that I am done with the hospital for a while!

I spend Christmas Eve with my parents wrapping gifts, planning the day-after-Christmas menu, and relaxing.  It has started to sink in that I could have just spent my last Christmas morning at home.  Though changes of this magnitude are never easy, I am quite excited to get married and start new holiday traditions with the Captain.  In any case, if this was my last Christmas morning at home, we ended on a high note.  I spent Christmas night with the Captain’s family and we went back to my parents’ house for the day-after-Christmas party that has become a tradition with my family.  We spent a few more days with my parents and then finished out the week (and 2011) with the Captain’s family. It was a whirlwind vacation but I had more fun than I’ve had in a long time.

Needless to say, there was a lot of wedding talk and planning.  We took engagement pictures, started our registries, picked invitations, and got my wedding band from the jeweler.  I’m getting into the main crunch time now and I have started making a list of all of the things I’d really like to accomplish this week.  I don’t know how much free time I’ll have since I start a 2 week small animal medicine rotation tomorrow, but at least there is a lot I can do on the internet.  

I should find out at the end of the month whether or not I passed the NAVLE.  Additionally, I have to start applying for jobs now that I know what state the Captain and I will call home.  He was recently hired by an airline (I can’t wait to see him in his uniform!) and he will by flying by March.  I’m so proud that he is taking this step in his career, and I’m glad he kept his end of the bargain by letting me know in January where I should be applying for jobs.  I checked my veterinary school job posting website this morning and the first clinic with a listing in the right area sounds like the perfect place to work.  Seriously, I think I started drooling when I looked at the website and saw that not only are they AAHA-accredited but they also have digital radiographs (one of the same systems we have at school), digital dental radiographs, 4 doctors, and 10+ CVTs that have been with the practice for 3 years or more (many, many more in some cases).  Needless to say, polishing my resume and drafting a cover letter will be my number 1 priorities over the next week or so.  I know that a practice of this caliber will receive a lot of applicants (especially since they will take applicants with any experience level, even a soon-to-be recent graduate), and I want to give myself the best chance possible for an interview.  The job hunt is scary but finding listings like this one make it exciting.

On that note, I have to make sure to get a full night sleep before starting internal medicine tomorrow.  I have a feeling that it’s going to be tough to get back into the swing of things after all of this excitement!   Until next time!

1. Took the NAVLE (national boards).  Holy cow, that was intense.  I took 6 of the 7 allotted hours to take the exam (including one 10 minute break and one 20 minute break) and when it was over, I just stared at the computer screen as it cycled away from my exam and back to the default login screen for the testing center and thought “wow, it’s over.” I’ll get my results sometime in January.  I’m hoping that the state where I’m applying for my license has the same online method for checking your pass/fail status as the state where I am going to veterinary school.  If I have to wait for the official results in the mail when all of my friends can check online, I may go nuts.
2. Spent Thanksgiving with the Captain and his family.  Holidays with the future in-laws remind me of the holidays I used to spend at my Grandmother’s house when she was alive.  I love having everyone in the same house and I love the smell of roasting turkey and all of the sides (even though I’m not a big fan of the turkey itself!).  My own family hasn’t really done anything for Thanksgiving in quite a long time, so I feel truly blessed to be able to spend this holiday with my soon-to-be family.  As an added bonus, I’ve been going to the Captain’s family Thanksgiving for the past 9 years so they really feel like my own at this point.
3. Picked out bridesmaid dresses with the Captain’s sisters and with Best Friend.  All six of my bridesmaids get to pick whatever dress they want with very few limitations.  I want everyone in the same color and fabric and I want short dresses as opposed to long.  Since the Captain’s sisters were the first two to choose their dresses, they got to choose the fabric for everyone else.  The consultant at the store was amazed that I was so open to whatever the girls wanted.  I can imagine that they get quite a few bridezillas that require an army of bridesmaid clones.  I guess that’s just not me.  When I got back home after Thanksgiving, I went shopping with Best Friend and she chose her dress, too.  I still have to go shopping with 3 more girls, but everything is coming together nicely so far!
4. Bought wedding bands with the Captain.  That was an experience.  The Captain was in the first throes of Strep. throat and I’m pretty sure he was febrile.  After eating some chicken soup, he claimed that he was feeling much better and said that we should go shopping anyway.  So he may or may not have exposed an entire jewelry store to Strep. throat in the process of choosing a ring.  I really, really like the one he picked, though.  I had to have my ring custom-made because my engagement ring has a unique shape and there wasn’t anything that would go with it.  I’ll get to pick up my ring right after Christmas and I can’t wait to see it in person.  So far, I’ve only been able to see the wax model they made for me to approve before casting the actual band.  This whole wedding thing seems a lot more real now!
5. Spent a week learning about dog physical therapy.  PT was an amazing experience.  I’m blown away by the recoveries dogs can make with physical therapy.  The therapist at school is a human PT who has had extensive training in animal PT and she is extremely qualified to do what she does.  I hope that I can someday be as good as she is at communicating with clients.  She kept quizzing me on anatomy such in front of the clients and at one point, she said that she was really impressed at how much I knew about anatomy.  That was a bit of a shock to me considering I haven’t had anatomy since first year.  I guess I retained more than I thought I did!
6. Spent 2 weeks on an anesthesia rotation.  This is the first rotation I’ve had that is described as “sink or swim” by the clinicians involved.  Monday is called “minimal monitor Monday” and that is when all of the elective procedures take place (spays, neuters, declaws, etc) and they are done by 4th years on the soft tissue surgery rotation.  On anesthesia, you make up your anesthetic plan (choose which drugs to use and calculate the doses for the emergency drugs for your patient, etc.) The two monitors you can use are the pulse oximeter and the doppler for measuring blood pressure (though if there are any complications, the anesthesia department will definitely intervene.  It’s just an exercise meant to mimic surgery in general practice).  Once your plan is approved,  you pre-med your animal, place a catheter, induce anesthesia, intubate, set up your monitors, and roll into the operating room.  Then they leave you alone and check in every 30 minutes or so.  The rest of the days are the polar opposite.  You still make your plans but these surgeries are a lot more complicated and usually non-elective (mass removals, TPLOs to stabilize dogs that have ruptured their ACL, foreign body removal, just to name a few).  There are at least 3 monitors to hook up during surgery prep and then you hook them up to the expensive, human-grade monitoring equipment with digital displays and ventilators and all of the bells and whistles.  You settle in for a 3-4 hour surgery with at least 3 people scrubbed in (clinician, resident, and student on the case), however there may be many more (multiple residents or interns that are with that particular service at the time).  I have a healthy respect for anesthesia.  You are truly placing your animal’s life in someone’s hands and I completely understand why the anesthesia is usually the part of a procedure that frightens owners the most.  My first week was really rough because I was afraid to make a mistake.  I started to get a bit more comfortable by the middle of the second week but to say that I feel good would be a gross overstatement.  One thing I learned was exactly what monitoring equipment and drug protocols I’m going to ask about when I interview for jobs (provided I get some interviews in this market!).  I’m still on call for most of this weekend, but I’m for the most part, the rotation is over and I’m happy that my blood pressure can finally start decreasing back into the normal range.

That brings me to today/this weekend.  I have to stay close to my pager (and be within 15 minutes of the clinic) so that limits the amount of Christmas shopping I can attempt.  I did a lot of online shopping this year and had it shipped to my parents’ house. I’m leaving town at around 5:00 am on Monday morning to be able to get home and drop my cats off with my parents’ before heading to the local vet clinic for the start of my 1 week externship.  I worked at the clinic for a summer before I got into vet school so I know the basic lay of the land.  I haven’t been back in a long time and I’m excited to see how things have changed.  It will be  very different to spend time there now that I’m at this point in my vet school career.  I’m a completely different person now than I was when I was a junior in undergrad.  Overall, I couldn’t be happier.  This is a great way to be able to spend some time with my parents and get school credit at the same time.  After my externship, I have a week off to spend time with the Captain and do some more wedding planning.  This is shaping up to be quite a nice holiday break!

After spending more time at school during my 2 week medicine rotation than I did at home, I was hoping that my cardiology rotation would give me a bit more time to study for my national boards.  One week from Monday, I will sit for the most important examination of my life.  This is the exam that decides if I’ve learned enough in veterinary school to actually become a veterinarian.  I’ve been having nightmares for weeks.  I don’t know how I’m going to sleep as the day gets closer.  I planned my testing date very carefully.  It’s the Monday before Thanksgiving and I have the whole week off (I scheduled vacation time for this very reason).  I will take the exam on Monday, recharge on Tuesday (and sleep off the celebratory bottle of wine that will have been consumed Monday night), and go to my future in-laws house on Wednesday through the weekend.  I haven’t seen the Captain or his family since August and right now, they are the light at the end of the tunnel.  This is going to be a really special Thanksgiving break because it will include meeting our priest, wedding band shopping, and bridesmaid dress picking with my future sisters-in-law.  So many good things to come!

For now, I’m going to put my head down and keep pushing through.  I have over 1000 practice questions left to go through before the big day and an awful lot of information to learn about poultry diseases.  Oh, and I have to learn a bit more about cardiology before Monday.  What happened to relaxing weekends?!

I met some fabulous clients and some not so fabulous clients while on ortho.  That brings me to my real reason for posting today.  Some may think that this is a touchy subject, but I’d love some input from those who have been around the sun a few more times than I have.  I am always surprised at the things that clients will say in the exam room.  I had one woman that constantly called me ridiculous pet names (“oh, do whatever you need to do, honey”, “we don’t mind waiting, dear”, “thanks for taking such good care of Fluffy, sweetie”).   It made me laugh more than anything…she sounded like a grandmother.

I would now like to contrast the aforementioned experience to one I’ve had with a few older, male clients.  None of them make me laugh when I get comments like “I don’t know why Rover isn’t cooperating.  It’s not every day that he has a pretty girl examining him”, or “Wow, Rover has a bunch of female doctors?  Lucky dog!”  I don’t understand the reasoning behind making comments like these, and I’m having a hard time thinking of an appropriate way to respond.  For the first quote, I was alone in the room with the client so I kind of shrugged it off and kept going with my exam.  For the second quote, the resident and an intern were in the room and the resident gracefully redirected the client to talking about the surgery itself.  I’d love to say that there was some sort of generational gap, but I’ve seen clients of all ages make comments like these and it really makes for an awkward experience.  I have the urge to ask if they talk to their own doctor that way…or their lawyer, or pharmacist, or dentist.  I just know that over the course of my career, I’m going to get lines like these (or worse) and I’m going to have to come up with some good strategies for dealing with it so I can avoid the whole awkward silence afterward.  I would just like to know why people think that it’s appropriate to make comments about someone’s looks in the exam room.  I’m sure the answer is hiding somewhere with that magic injection clients keep asking for that will cure any illness.

Aside from my current deep thoughts, I’ve been spending my days on dermatology.  I made some treats to take in tomorrow for the last day of the rotation.  We get to wear jeans and I am crossing my fingers that we get let out early.  I’m also hoping that I have time to go visit my wedding dress.  It arrived in the store the other day and I just haven’t had a chance to get over there to try it on.  I’ve done a ton of wedding planning lately and I think putting my dress on will be a nice change from endless internet searches and phone calls to vendors.  This whole wedding thing is a lot of work.

On that note, I should get to bed so I am rested and refreshed for the last day of derm.  I’ll try to post more regularly now that I’m more comfortable with the flow of 4th year.  :)

Well, I want to make sure that I’m not one of them. I was giving shots and palpating on Monday, and I castrated my first calf yesterday. Throw in some dehorning, and I feel like I’d make James Herriot proud. Today it sounds like I will be doing some more injections (it is really, really hard for this small animal girl to get over the fact that you have to be more forceful with the needles to get through those hides!!) and perhaps I’ll be doing some more palpating. We will see how it goes.

I spent my afternoon on the small animal side of things (it was a slow day for herd checks) and I got to talk at length with one of the older vets about changes in procedures, pay, and veterinary school since he graduated. The small animal vet joined in later and told us that when she was being interviewed for veterinary school, the interview board actually said “why should we spend all this money to educate you when all you’re going to do is find a husband and have babies?” My oh my, how the times have changed. I started veterinary school in a class of 15 men and 65 women and that surprised both of the vets. They were in veterinary school at a time when women just didn’t do things like this. I have to say that I’m quite glad that I am pursuing this career at a time when I’m encouraged to do so. Even if I’m not really interested in the large animal stuff, I love talking to all of the vets. They have seen and done so much that is is hard not to be in awe.

Here is to trying new things and hoping that when I leave, the vets here may not be so hesitant to have a small animal girl ride along with them!

Emergency med has been crazy and I’m only going in to my 3rd full day tomorrow.  I technically had today “off” but I had a patient to examine and some paperwork to do before 8am.  And then the resident wanted to do some rounds.  Unfortunately, my patient was euthanized before I got there and instead of writing physical exam findings, I had to write a death report.  I really wanted this patient to make it. He was a special cat who suffered a traumatic injury.  And when I was taking him out of his cage to flush his wounds, he bit me and sent me to the human ER for antibiotics.  I figure if he had that much pizzazz, he deserved another shot at life.  Alas, you can’t save them all.  I was a little shocked at how my ER visit went.  I was triaged right away and I actually got called to be examined relatively quickly.  I saw a nurse, a 4th year medical student, someone who I think was a resident or intern or something, and someone who was a senior clinician.  Then I got to talk to billing, which was a woman with a rolling table and laptop who collected my insurance information. And then the nurse came back to give me my prescription and some ridiculous discharge instructions.  I couldn’t believe the song and dance I put up with all for a piece of paper.  They didn’t even clean the bite for me (which was probably fine because I had already washed it at school and soaked it for 10 minutes in chlorhexidine scrub and warm water.  But that’s neither here nor there).  I can’t imagine sending a client home with a bloody pet.  So why did I get sent home with a bloody hand?  Apparently good bedside manner is an art form.

After I finish emergency medicine (and provided I make it out with all of my appendages attached), I have a 2 week rotation in ambulatory practice.  I was assigned to a large animal clinic in the area and I have to assist their vet on calls.  It’s about 90 minutes away from my apartment so I may end up staying at the clinic during the week and just coming home on the weekend.  I guess it will depend on what time I have to be there each morning.  I don’t think I’d mind the drive if I got to sleep in my own bed each night.  However, I would not be happy paying that gas mileage…We’ll see how it goes.  After this rotation, I’ll be 2/3 done with my large animal requirements.  Once I finish large animal surgery in February, I can promptly purge any horse and cow knowledge I possess (that is unless I don’t pass boards the first time and I have to take them again in April.  Then I suppose I should retain my large animal knowledge until then, at least).

I can’t believe how quickly these rotations seem to pass.  It’s scary and amazing all at the same time.  I am counting down to so many great things in 2012 and it will be here before I know it.  In the meantime, I feel like I have a lot of studying to do!

By far, the best part about this rotation is seeing small animal clients.  I went from appointment to appointment and I was having so much fun that I didn’t realize that I was hungry for lunch until it was 4pm.  I know I probably won’t always be this enthusiastic, but I had one of those moments yesterday when I realized that I’m on the right career path.  I was in the room with a client and his dog and I had just finished checking intraocular pressures and I had just started doing a fundic examination using indirect ophthalmoscopy (shining a light from near my eye toward a lens near the dog’s eye).  I managed to get the optic nerve into the field within seconds.  I had to smile to myself at that moment because I have never felt so much like a doctor as I did at that point in time.  It probably sounds silly, feeling like a professional because I could see the optic nerve, but I’ve never been able to find it so quickly before.  So I’m going to celebrate the small victories and say that I love seeing appointments.  We will have some rechecks in the morning and I’m already going through a checklist on how to streamline my ophthalmic examination and how best to ask questions to take a good history.  This is what I’m supposed to be doing.

Ophthalmology has shown me how nice clinicians and residents can be.  I’ve made a couple mistakes (mainly doing tests when they were unnecessary) and instead of jumping down my throat and telling me that I did something wrong, my residents says things like “We usually don’t do schirmer tear tests on recheck appointments, but you did it this time and that’s OK.”   And if I don’t come up with the right answer in rounds, my clinician says things like “Hmm, not exactly…but you’re on the right track.”  I feel extremely supported and that makes me work harder.  Working harder means that I learn more.  Learning more makes me feel like a professional.  It’s a great positive feedback loop and such a welcome change from my past rotation.  I can’t wait to see more!!

On Friday night, I got called in to take in an emergency patient with my resident.  I’ve had mixed feelings about my resident all week because she was overheard making a comment to the surgeons about how “Veterinary Student is small animal…She probably won’t feel comfortable calling the owner of the foal she’s been taking care of all week” (side note: I called the owner and it was fine.  Clients are clients and I got to deliver good news).   Anyway, I’m SO glad I got the chance to work with my resident on a case by myself.  I got to see a different side of her and I think I showed her that I’m not as prissy as she thought I was.  She has been treating me much more like a colleague since then.   I’m still upset with how my clinician treated me, but I’m glad that I get to end this rotation on a happy note.  And our ER patient is still alive.

Needless to say, I am really excited to be starting ophthalmology tomorrow.  The ophtho clinicians are really great and while I know I won’t know all the answers, I’ll at least have the chance to be myself.  I’ve picked out my outfit, ironed my pants and my lab coat, and read the ophtho manual.  I’m as ready as I’m going to be and I’m going to hit the ground running!  Hopefully my next post will be much happier than this one!