Ok people, today was a horribly depressing day for the Oncology department. Two patients were euthanized and two more discontinued treatment, which essentially means that they have no more options and the treatment is not helping enough to justify it being continued. Crappy. Therefore, I don't care to blog about it in detail so I'm going to blog about something random regarding my current life in Auburn, Alabama.
Work aside, today was a glorious day. Why you ask? Because I found a real, new, beautiful, wonderous grocery store contained within a splendidly fantastic shopping center that makes me feel as if I really am in a civilized part of the post 1987 United States. Keep in mind that I have been living in Denver (read tree hugger central where tofu is more prevalent than spam) and perhaps have been spoiled slightly over the last year and a half. Prior to today I had been shopping at the Winn-Dixie down the road. Now, it wasn't horrible or anything but let's just say that several of the staple items in my diet and any acceptable substitutes were unavailable, oh AND the block of cheese I bought there was EXPIRED! Do NOT mess with my cheese people, I don't tolerate that well.
Anyway, I decided to meander on down to the "Tiger Town" Shopping Center (it's the Auburn Tigers if you were wondering) and it was much like I imagine entering Heaven's pearly gates would be. The shopping center is brand spanking new and it contains many of the most wonderful stores and restaurants on the planet. These include Target, PetCo (they are one of the few that carry my cat's food), Moe's Southwest Grill, Chick-fil-a and last but certainly not least the oasis in the desert of groceryville...Kroger. Oh sweet Kroger, I love you dearly with your deli/bakery, your expansive produce section containing items that don't appear to have been shaken in a box like a maraca, your natural foods section with my favorite ever granola, a respectable beer selection containing options other than bud and miller light and perhaps the most important component of any quality grocery store...the gourmet cheese island. Unfortunately, it is not an actual island made of cheese but a refrigerated structure containing an extensive selection of quality cheeses. Were it actually a landmass composed entirely of cheese, I may be convinced to move here long term given I also had a dedicated team of medical health professionals to continuously monitor my condition as I embark on a dairy-only diet.
I had to restrain myself from dancing a joyous jig amidst the fresh produce, meats and organic foods. Although I don't really ever actually purchase organic anything, I was overjoyed to know that, if I really wanted acai juice with no preservatives and some organic-y something or other, I could have it. Also, within that glorious section, I found my most favorite granola ever in the whole wide world which, before leaving Denver, I seriously considered buying in bulk to get me through my ten weeks down here. But alas, I have found it and my mornings shall once again be full of whole grain and protein. What better way to end a crappy day than to have granola and non-expired cheese in my kitchen and a cold Tommyknocker Jack Whacker Wheat Ale in my hand?
I knew the Deep South was making progress, I just knew it.
Thursday, March 31, 2011
Wednesday, March 30, 2011
Week 1 Part 2- Oncology with a splash of Neuro
I can't believe it's only day 3 of internship. I've seen so many things already, I can't imagine how much stuff I'll have seen and done by the end of all of this. I kind of thought that I would be ridiculously nervous every day of internship at least for the first week or two, but I wake up in the morning excited to get to the hospital and get the day started. Maybe I am actually prepared for this after all, what a crazy thought! Thanks Bel-Rea! :)
Today I helped out again with radiation therapy for a little while in the morning. I think I was mildly more useful today since I had some sense of what was going on and had seen the same patients the previous day. One of the patients who is receiving radiation for an oral tumor was starting to show signs of dermatitis from the radiation. It also doesn't help that he's had part of his mandible removed and drools excessively and near constantly. So I shaved down that area and cleaned it up a little while he was still sedated...poor kid.
After that I restrained about a zillion animals for a zillion different things from catheter placement to physical exams to a quick blood pressure reading with the Doppler. The vet students there are often stressed to the max (I can see it in their ginormous eyes and terror-stricken faces) and need people to help them restrain and what not for their patients. I got dragged around the place by an ill-mannered Shar-Pei at one point and had the red inflamed forearms to prove it. Restraining her was like hugging a cactus...a moving cactus.
We also had a Maine Coon cat come in who previously had surgery to remove a fibrosarcoma from her lateral abdominal area. Apparently, not all of the margins came back clean so she was in for more treatment. She had CT scans for diagnostic purposes and also to determine parameters for radiation therapy. It was cool to see an actual CT scan outside of some medical TV show and it was amazing how clear many of the organs and body structures were...way better than the lava lamp ultrasound.
Onco-land got pretty slow after that so I jumped over to the Neuro department (my favoriiiiiiite!) and got to see a diagnostic EEG performed on a dog. An EEG is basically a recording of brain activity gathered from a group of maybe 9 or 10 probes that are inserted into the skin all around the top of the animal's head. It looks a lot like an ECG printout from a reading of the heart's electrical activity. There were a few phases of the EEG, one included a light flashing in the animal's face at various speeds to determine if it elicits a seizure response. I wasn't able to wait around for the vet to interpret the results but will hopefully get to at least drop by there tomorrow to see what is going on with that patient.
Another fun-filled day at Auburn over. I'm hoping to spend a lot more time in the Neurology department but I'm trying to get as broad of an experience as I can so I'm sticking with my rotations for now.
Have a great week everyone! Thanks for reading my blog, let me know if you have any questions or things you want me to talk about that I haven't covered.
PS- That dog I monitored anesthesia for yesterday is doing well. They left his incision open yesterday and just packed it. Today they inserted a drain and closed it up...cool!
Today I helped out again with radiation therapy for a little while in the morning. I think I was mildly more useful today since I had some sense of what was going on and had seen the same patients the previous day. One of the patients who is receiving radiation for an oral tumor was starting to show signs of dermatitis from the radiation. It also doesn't help that he's had part of his mandible removed and drools excessively and near constantly. So I shaved down that area and cleaned it up a little while he was still sedated...poor kid.
After that I restrained about a zillion animals for a zillion different things from catheter placement to physical exams to a quick blood pressure reading with the Doppler. The vet students there are often stressed to the max (I can see it in their ginormous eyes and terror-stricken faces) and need people to help them restrain and what not for their patients. I got dragged around the place by an ill-mannered Shar-Pei at one point and had the red inflamed forearms to prove it. Restraining her was like hugging a cactus...a moving cactus.
We also had a Maine Coon cat come in who previously had surgery to remove a fibrosarcoma from her lateral abdominal area. Apparently, not all of the margins came back clean so she was in for more treatment. She had CT scans for diagnostic purposes and also to determine parameters for radiation therapy. It was cool to see an actual CT scan outside of some medical TV show and it was amazing how clear many of the organs and body structures were...way better than the lava lamp ultrasound.
Onco-land got pretty slow after that so I jumped over to the Neuro department (my favoriiiiiiite!) and got to see a diagnostic EEG performed on a dog. An EEG is basically a recording of brain activity gathered from a group of maybe 9 or 10 probes that are inserted into the skin all around the top of the animal's head. It looks a lot like an ECG printout from a reading of the heart's electrical activity. There were a few phases of the EEG, one included a light flashing in the animal's face at various speeds to determine if it elicits a seizure response. I wasn't able to wait around for the vet to interpret the results but will hopefully get to at least drop by there tomorrow to see what is going on with that patient.
Another fun-filled day at Auburn over. I'm hoping to spend a lot more time in the Neurology department but I'm trying to get as broad of an experience as I can so I'm sticking with my rotations for now.
Have a great week everyone! Thanks for reading my blog, let me know if you have any questions or things you want me to talk about that I haven't covered.
PS- That dog I monitored anesthesia for yesterday is doing well. They left his incision open yesterday and just packed it. Today they inserted a drain and closed it up...cool!
Tuesday, March 29, 2011
Week 1 Part 1- Oncology!
Alright people, I'm experimenting with how to approach this blog thing so, if this is mind-numbingly boring, please let me know ASAP so I can change things up...
My first rotation is oncology (all things cancerous for my non-medical oriented pals). I guess I was a little hesitant about this one initially because it has the potential to be thoroughly depressing. But, at the same time, it's something we didn't cover in depth in school so there is so much to learn and so many new things to see.
Monday started out right away with jugular blood draws so that we could get blood work on our chemo patients. It was at this point that I discovered, as I had suspected, that though I am not completely incompetent at getting blood from the jugular, I am certainly no professional either. So begins my list of skills to work on over the next few weeks/months/years. There are acceptable ranges for certain CBC (complete blood count) values before administering chemo so it's important to get those results back before treatments are given. I got to observe the first IV chemo treatment and restrain an ultra sneaky German Shepherd for the second treatment, I had to smother/tackle her a few times but the catheter stayed in and she got her treatment despite her valiant efforts to prevent it. On Tuesday, I got to administer chemo to a little poodle, he was a champ. Auburn has about 15-20 different types of IV chemo drugs as compared to a regular clinic which may have about 4 if they do chemo treatments at all.
Later in the day on Monday, I helped restrain for an exploratory procedure on a dog who previously had a rectal mass and was suspected of having another one. Unfortunately, there was another mass so a biopsy was performed requiring brief anesthesia, monitored by yours truly.
The cool thing about the University hospital setting is that there are about a gazillion things going on at once, so we finished up with the biopsy and headed over to observe a procedure in nuclear medicine to determine kidney function/glomerular filtration rate(GFR). The dog was given a radioactive substance attached to a drug which is filtered by the kidneys. The path of the substance can be monitored and, based on different variables and a mathematical formula (of which I do not even remotely understand), GFR can be determined, crazy. After that we went over to ultrasound where they were scanning a dog with tumors throughout it's abdomen. They used the ultrasound to aspirate some of the masses in order to do cytologies and determine what type of masses they were. At this point, ultrasound images look to me like someone is taking a super close-up black and white video of a lava lamp, but occasionally I can pick out some random organ or structure so that's something right?
On Tuesday morning I spent some time down with the nuclear accelerator which, let's admit, just sounds really cool. The machine is used to do radiation therapy with oncology patients. There is a whole process of taking "portal films" which are compared to scans of the tumor and used to determine where the radiation beam is directed. The films are a lot like radiographs and are developed the same way. I developed a couple of those and helped where I could with positioning and moving patients, oh and epically failed at another blood draw (positive thinking, positive thinking).
After the aforementioned poodle chemo, I got to monitor anesthesia for a septic abdomen surgery. The patient had abdominal surgery a few days prior and was showing signs of possible dehiscence of the intestinal incision. Though it wasn't the best for the dog, it was a great experience for me to be part of an anesthesia that was not perfect. The entire time, the dog's blood pressure was extremely low. I could almost hear Janet's (my Anesthesia instructor) voice in my head asking what we can do if the blood pressure is too low. We pretty much exhausted all of our options: lower the vaporizer setting, bolus fluids, give colloids, give dopamine, give Solu Delta Cortef...all to no avail. He made it through surgery and was whisked off by the vet students in charge of his case so I didn't have any part in monitoring his recovery (there's Janet's voice again, gasping that I shirked my anesthetist duties in not recovering the patient). I felt like I knew what I was doing monitoring everything and recording it, I even did a little sterile teching here and there (Jessie's voice: Dainty!!) After a little clean up duty, my day was done.
So far I've seen some cool stuff and feel like I'm getting some great experience. Hopefully, you haven't clawed your eyes out from boredom by now. Leave comments if you have any suggestions on how to make this more reader friendly!
My first rotation is oncology (all things cancerous for my non-medical oriented pals). I guess I was a little hesitant about this one initially because it has the potential to be thoroughly depressing. But, at the same time, it's something we didn't cover in depth in school so there is so much to learn and so many new things to see.
Monday started out right away with jugular blood draws so that we could get blood work on our chemo patients. It was at this point that I discovered, as I had suspected, that though I am not completely incompetent at getting blood from the jugular, I am certainly no professional either. So begins my list of skills to work on over the next few weeks/months/years. There are acceptable ranges for certain CBC (complete blood count) values before administering chemo so it's important to get those results back before treatments are given. I got to observe the first IV chemo treatment and restrain an ultra sneaky German Shepherd for the second treatment, I had to smother/tackle her a few times but the catheter stayed in and she got her treatment despite her valiant efforts to prevent it. On Tuesday, I got to administer chemo to a little poodle, he was a champ. Auburn has about 15-20 different types of IV chemo drugs as compared to a regular clinic which may have about 4 if they do chemo treatments at all.
Later in the day on Monday, I helped restrain for an exploratory procedure on a dog who previously had a rectal mass and was suspected of having another one. Unfortunately, there was another mass so a biopsy was performed requiring brief anesthesia, monitored by yours truly.
The cool thing about the University hospital setting is that there are about a gazillion things going on at once, so we finished up with the biopsy and headed over to observe a procedure in nuclear medicine to determine kidney function/glomerular filtration rate(GFR). The dog was given a radioactive substance attached to a drug which is filtered by the kidneys. The path of the substance can be monitored and, based on different variables and a mathematical formula (of which I do not even remotely understand), GFR can be determined, crazy. After that we went over to ultrasound where they were scanning a dog with tumors throughout it's abdomen. They used the ultrasound to aspirate some of the masses in order to do cytologies and determine what type of masses they were. At this point, ultrasound images look to me like someone is taking a super close-up black and white video of a lava lamp, but occasionally I can pick out some random organ or structure so that's something right?
On Tuesday morning I spent some time down with the nuclear accelerator which, let's admit, just sounds really cool. The machine is used to do radiation therapy with oncology patients. There is a whole process of taking "portal films" which are compared to scans of the tumor and used to determine where the radiation beam is directed. The films are a lot like radiographs and are developed the same way. I developed a couple of those and helped where I could with positioning and moving patients, oh and epically failed at another blood draw (positive thinking, positive thinking).
After the aforementioned poodle chemo, I got to monitor anesthesia for a septic abdomen surgery. The patient had abdominal surgery a few days prior and was showing signs of possible dehiscence of the intestinal incision. Though it wasn't the best for the dog, it was a great experience for me to be part of an anesthesia that was not perfect. The entire time, the dog's blood pressure was extremely low. I could almost hear Janet's (my Anesthesia instructor) voice in my head asking what we can do if the blood pressure is too low. We pretty much exhausted all of our options: lower the vaporizer setting, bolus fluids, give colloids, give dopamine, give Solu Delta Cortef...all to no avail. He made it through surgery and was whisked off by the vet students in charge of his case so I didn't have any part in monitoring his recovery (there's Janet's voice again, gasping that I shirked my anesthetist duties in not recovering the patient). I felt like I knew what I was doing monitoring everything and recording it, I even did a little sterile teching here and there (Jessie's voice: Dainty!!) After a little clean up duty, my day was done.
So far I've seen some cool stuff and feel like I'm getting some great experience. Hopefully, you haven't clawed your eyes out from boredom by now. Leave comments if you have any suggestions on how to make this more reader friendly!
A few links
For anyone unfamiliar with either Bel-Rea or Auburn University, here are links to both programs:
-Bel-Rea
-Auburn University- Veterinary Medicine
-Bel-Rea
-Auburn University- Veterinary Medicine
Woohoo! Internship!
So here I am, way deep down in the South with 18 months of school under my belt and my stethoscope at the ready. On one hand, I'm completely freaking out that I'm an intern and on the other I'm uber-excited for all of the opportunities that I'll have over the next ten weeks. The turbo nerd in me is saying that I need to restudy every morsel of information that I've ever been taught and the semi-confident chill person in me (I swear she IS in there) is saying to relax and take every opportunity to practice skills, reinforce information and learn new things. So, I'm trying to listen to the chill one and just add an occasional dash of turbo nerd as needed. We'll see how that works out for me.
I'll update this blog when I can with details on what I've been doing and my random thoughts along the way...
I'll update this blog when I can with details on what I've been doing and my random thoughts along the way...
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