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!