Saturday, December 26, 2009

It's Like Christmas

After classes ended, I wanted to start reading a book for fun and I had 2 to choose from that I bought back in August: "All My Patients have Tales" by Jeff Wells AND "Tell Me Where It Hurts" by Nick Trout. Yes, that's right I read about veterinarians for fun when I'm not studying. Talk about well-rounded. Anyways, Nick Trout is a surgeon so I started reading his book and was hooked. I highly recommend this book to any aspiring small animal vets and especially surgeons. He explains clinical diseases and techniques very clearly but not too simple since I was still learning more about procedures I was somewhat familiar with. He also has enough humor to keep it entertaining. In the first chapter, he talks about a dog with GDV (gastric dilatation and volvulus). Briefly, it usually occurs in deep-chested dogs after a big meal. During exercise, the stomach twists (volvulus) and the gas being produced during digestion? becomes trapped - dog is unable to burp - and results in a bloated stomach (gastric dilatation) with no way to release the pressure. Obviously, the dog does not feel good and time is important because the twisting can cut off blood supply to the stomach as well as the spleen.
Up until today, my job at the teaching hospital has been rather boring. We have 3-4 people giving treatments to 2 animals in the mornings. One day, I barely did anything because we have too many people doing too little work. Today, I got to take care of a German Shepherd with Myasthenia Gravis (animal's body makes antibodies to acetylcholine receptors ->dog gets stiff/tired after exercise) and possibly secondary megaesophagus. This dog looked terrible 3-4 days ago - not moving much, not eating much, salivating a ton. Today, the dog went for a walk outside, wasn't salivating much, and scarfed down a can of food. He may have even gone home today. It was fun talking to the doctor about myasthenia gravis and its treatment/prognosis. It's a good chance to see what I know and what I have to learn. There are a few drugs to treat myasthenia gravis, but the important thing to look for are acetylcholinesterase inhibitors.
I was also on-call for surgery today. My plan was to sit at home and watch movies all day until my phone rang and I was called into surgery for an emergency GDV. It was an answered prayer to scrub in on the surgery. I am still struggling with finding the arm holes for the gown, but the rest of the scrubbing and gloving went fine. I always find one arm hole and have no clue where the other is. I gowned up and was put in charge of suction. We immediately removed 1 liter of bloody fluid from the abdomen. At this point, I was thinking, "Oh great, my first real surgery I get to scrub in and it's going to bleed out." My thinking seemed to be confirmed when we could not find the source of the blood and 1 liter approached 2. Finally, we found a broken vessel and ligated it. The rest of the surgery went fairly smoothly and I can add retracting and cutting suture to my resume'. The surgery was a couple hours long due to all the complications.
In the middle of that last paragraph with 5 minutes left for being on call, I was called in again by the surgeon. He said he could get someone else, but I couldn't pass up another opportunity to scrub in. This one was a pyometra (pus in the uterus). I arrived to finish scrubbing the patient. Gowning went much smoother this time. Just before the surgery, I confirmed that the point of the surgery was to just remove the uterus which is what we did. The surgery only lasted 20-30 minutes. Tomorrow we meet to write the surgery report and discharge - things I was asked to do, but won't learn until next year.
To put the cherry on the top of my GDV and pyometra filled cake, I got paid for all of this that I would have done for free. I love my job!!!


HP said...

Hey! I came across your blog and I am a 2nd year vet student as well. I read "Tell me where it hurts" last summer and LOVED it! Your job sounds awesome (at least what you got to do today) - I work in my school's diagnostic lab - not quite as exciting I'm afraid :) good luck with school!

Polka Dotted Pickles said...

Wow! :) Sounds super interesting and I am also writing down the book recommendation. :)