Anesthesia Rotation

I honestly was a bit terrified before starting this rotation because I had weird problems that happened during sophomore and junior surgery (apnea- not breathing on their own, waking up while heading to the OR (operating room), and things of that nature).  I actually have been enjoying my time even though there are times when my heart still races.  It is not too bad of a rotation, but it does solidify the fact that I do not want to pursue this as a career for the future :) It is just way too much stress and responsibility resting in your hands.

I struggled in the core anesthesia class because I could not picture the microscopic phenomenon that occurs when a drug is given or when the blood pressure decreases or when heart rate increases or when the patient stops breathing all of a sudden and so forth.  Going over all the lecture notes while taking this rotation greatly solidified some concepts that I could not grasp when just sitting in the classroom and taking notes.  Sophomore and Junior Surgery was also great kinesthetic practice for preparing for this anesthesia rotation.

I have improved tremendously with doing drug calculations after taking this rotation!  I loved that they give us a drug sheet with all the available anesthetic and analgesic drugs with their proper concentrations and drug administrations. It made the calculating process run more smoothly.

drugs

Life Saver!

You will get a lot of hands-on experience. You give the injections such as the premedication drugs, induction drugs, and even pain therapy drugs like an epidural (injecting an analgesia, usually an opioid, into one of the layers just outside the spinal cord to help numb the area being treated). You also get all of the equipment and station ready for the patient, place the catheter in the cephalic vein found on the dorsal-medial aspect of the antebrachium which is distal to the elbow of the front limbs or in the saphenous vein found in the lateral aspect of the hind limbs, and intubate the patient.  A lot of doctor–related decisions for when problems arise occurs very frequently.  Be ready and prepared for those situations by reviewing past anesthesia lectures and notes from rounds because changes within a patient (ex: apnea, tachycardia, hypotension, hypothermia, hemorrhage, etc.) can happen very fast.

On occasions, you will be monitoring alone with the patient having a procedure.  Do not panic though!  You will always have a technician pairing up with you for a case.  During the first week, they will be in the room with you and will rarely leave.  Later on, they begin to trust that you are getting used to monitoring the patient on your own and will leave for longer periods of time but always will check back with you to make sure everything is fine.  Technicians are extremely helpful and patient.  They will either be people who work here at the hospital, or they may be your classmate who took this rotation already and is now considered as the tech.  I was so surprised and encouraged for how much my classmates knew after taking this rotation for only 3 weeks!

Making the best drug protocol for a patient is still a bit of a challenge for me.  There is so much to consider before sticking with a drug.  What is the patient’s major health concerns, and will this drug make the patient worse while under anesthesia?  Once you feel comfortable that the drug’s contraindications will not affect the patient, it should be safe to administer.  Just remember that there will never be a perfect drug.

 

 Here’s what other people had to say about it!

(What was Orientation Day like?)

-Met in the prep room (huge, long room by Imaging services) at 7AM to get a quick introduction for how they operate and where supplies are located. We received a laminated drug sheet first day that is extremely helpful for the rotation and future. Try not to lose this handy tool.

(Average Daily hours on duty?)

-7:30AM-5:30/6PM (including AM and PM rounds)

-7:30AM-6/6:30PM With one doctor, morning rounds @ 8A, evening rounds @ 5PM

(What is the attire?  When do you change into scrubs?)

-scrubs and white coat (supposed to change into scrubs once in building to keep them “clean”)

-make sure to always put your white coat back on after leaving the OR area. It is easy to forget, but it is to prevent any hair or blood to land on your scrubs before going back to the OR for another procedure. Have one extra pair of scrubs in your locker.

(What do doctors/residents/techs constantly harp on?)

-Have all your stuff and be prepared. Morning rounds is exactly 8AM (some doctors hate latecomers), but you need to have your stations set up for your patients by then (so get there 7:30AM or earlier).

-Know your differential diagnosis for CBC or Chemistry abnormalities. You will some times be asked to explain what causes elevated sodium levels or decreased anion gap and so forth.

-Don’t forget to give Cefazolin (an antibiotic) via IV to your patient undergoing surgery every 90 minutes. This one takes 10 minutes to administer, so it is easy to forget to re-administer this drug and to give it very slowly also.

(What are some struggles to watch out for?)

-Inconsistent lunch breaks  (have snack bars on you at all times to eat in the changing room!). People on-call have been there up to 1-3AM, be ready to be there if you’re on-call (whether it’s primary or secondary on-call)

-You may finally be able to do an epidural without assistance, but then you notice the administration was still unsuccessful because the patient is tachycardic and hypertensive during the surgery (meaning the patient is painful). Don’t beat yourself up if it did not work. Just make sure you have other pain meds such as Hydromorphone or Fentanyl to help facilitate the problem.

-Some times, students in other services forget to write where the patient is located, so you have to walk a lot to try and find where the student or the patient is to get more information about the particular case. If you ever have to write up an anesthesia form, please write where the patient is. It will help us out greatly.

(Words of encouragement)

-It can be very overwhelming and nerve-wrecking, but really rewarding. You get the chance to do and learn a lot with direct supervision and guidance (lk epidurals, brachial plexus blocks, lots of intubation/ catheterization). The more work/ effort you put into it, the more you’ll get out of it! Also, teamwork is a must!

(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)

2 out of 3

3- our block was constantly busy and would sometimes have up to 12 requests to work up for the next day (good news is that you never have to write up discharges or put in any requests for tests or imaging)

Through Him,

~Camille

1 Corinthians 6:19-20= “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God?  You are not your own, for you were bought with a price.  So glorify God in your body.”

Oncology Rotation

Wow, Oncology.  Where do I begin?  Well, a classmate texted me halfway into the rotation and asked if doing this rotation was worth her time.  Absolutely, there was no hesitation!  I learned so much during these past three weeks that it is so impressive to look back on everything I witnessed.  Every day, I noticed that I was visually intrigued by almost every patient that came in for treatment.  Cases ranged from osteosarcoma amputated dogs to cats with injection site sarcomas, oral tumors, and anything else that involved some sort of mass observed externally or internally.  I will gladly share my pros and cons with this rotation and share some weaknesses that I greatly improved on during the course of the 3 weeks.

If you need more time with learning to communicate and empathize with owners, this is the rotation you need to sign up for.  On many occasions, you will have the opportunity to practice consoling with distraught owners who may have just heard sad news or will have to unfortunately euthanize their pet.  It is one of the hardest things seeing an owner looking shocked or devastated and then try to find the right words to comfort them while also explaining the process of how a particular cancer works.

The resident veterinarians I worked with were fantastic teachers.  From doing topic rounds, one-on-one discussions, and even being with them in an exam room with the clients, you can tell that they have a passion for this particularly field of medicine.  I also appreciated how the veterinarians structure their written discharges.  The diagnosis for the animal is the first information you read in the beginning of each discharge.  Rather than searching through the entire discharge to figure out what the patient has, this format saves so much time.

My favorite rounds were the jeopardy games each Friday where we were quizzed on various cancer facts that we learned thus far.  It was a great review for me.  Our group name was called “Magnificent Malignancies” while the other team was “Dirty Margins”.  We had fun :)

Midway through the rotation, each student had a sort of “midpoint- feedback discussion” with one of the residence who was the leader for our block.  Let me tell you how rewarding and encouraging that talk was for me.  One of the areas I really need to work on is my confidence.  She did say though that my strong points were having a gentle spirit, a deep love and care for each patient, and good communication skills with clients.  Those words truly warmed my heart because I really do care about these precious animals, and I want to make sure that each owner can trust that I will take good care of them.  I was then asked if there was anything the oncology service could improve on, and I felt compelled to be honest and share what was on my heart. In the initial stages of this rotation, I occasionally felt disconnected with the veterinarians.  As time progressed, I noticed that the veterinarians took more time to inform the students of what was going to happen next with their patient.  They also gave more feedback on whether or not our plans for our patient will be beneficial or not.  It just felt more like a collaborative effort instead of just shadowing a case.

Overall, I really enjoyed myself, and I highly recommend taking this rotation!

 Here’s what other people had to say about it!

(What was Orientation Day like?)

-Not stressful, performed PE. Signed up for 1 case today, will have 2 tomorrow. Its easy to hop on other cases so you can learn about all of the cancer types. You are on call on the days you sign up for, but wont usually have to come in at night. If there is a transfer patient you have to be there at 7:30 to be a part of transfering rounds and treat the patient before your regular shift starts. Bring a note book to write down things about your patient and to do lists. Bring stethescope, pen, and notebook. If you have to schedule a doctors appointment do it friday because we do not see appointments on fridays. 

(Average Daily hours on duty?)

8AM-5:00PM

(What is the attire?  When do you change into scrubs?)

-Business Attire

(What do doctors/residents/techs constantly harp on?)

You get to know what your case will be the day before. Review the specific cancer that night. Doctors will always ask what is the behavior of the tumor (locally invasive, highly metastatic?), where the tumor can metastasize to, proper drug protocol, and prognosis. Once you know these, you should be good for the fundamentals 

(Words of encouragement)

These residents and faculty are fantastic teachers. You will learn a lot during rounds and working with the patients. I really enjoyed Jeopardy rounds that covered all the topics for the week 

(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)

1 out of 3

Through Him,

~Camille

1 John 4:18= “There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love.”

Cardiology Rotation

What a fantastic rotation to start off with at the hospital!  The environment in the service has this ambience of low stress.  The doctors are extremely low-key and patient with you.  On average, each student is getting only one case a day, so you don’t feel like your insides are turning to mush with the burden of keeping up with multiple tasks.  If you are like me, I love to slowly inch my way in the water before submerging into its depths.  Baby steps is my safe haven before I’m thrown out in the wild to defend for myself.

I also am glad I took this rotation first because I can appreciate heart and respiration sounds better and apply it to future physical exams.  Now, instead of just finding the heart and getting only the heart rate, I am patiently listening to all the chambers and areas within the heart on the right and left side of the body.  I am also taking the time to feel for the pulse (usually the femoral arteries in both hind limbs) while at the same time listening to the heart to see if the pulse is synchronous with each heartbeat.

A senior student who was working in my rotation said something that was very insightful, and I would love to share it with you:

Think of every rotation like a cycle.  The first week, the doctor will ask you questions, and you will struggle answering them (just make sure to review later).  The second week, you’ve now got your hands dirty and have a better understanding for the given specialty you are currently involved with.  Third week, you are more confident with your answers and techniques. Then BAM.  A new rotation commences, and the cycle repeats itself.

It’s a cool way of approaching a new rotation because it forces you to have more humility.

A new heartworm treatment protocol is now available for veterinarians to use, and it’s found here:               http://www.heartwormtoolkit.com/

Here were other great websites to use while on this rotation that helped me:

http://www.vetmed.ucdavis.edu/vmth/small_animal/cardio_kittleson/cases/cases.htm

http://www.rvc.ac.uk/Review/cardiocases/  (just one case though…)

 

 Here’s what other people had to say about it!

(What was Orientation Day like?)

-Our time to arrive was nice (8:30am). We had instructions emailed to us 3 days before orientation day, and attached to the email was an orientation packet and 17 articles to look over (common things you will see in these patients). All we needed to bring was our stethoscope, pen, and a small notebook. The appointment schedule will be on the board. The discharge instructions for these cases are located in the box just below the board. You are asked to go ahead and sign up for a case on the first day. You are also asked to write your phone numbers on the larger board in the upper right-hand corner.

The doctors chose to have juniors shadow seniors for the first day (won’t be like that when the seniors leave). You go do your Hx first then a tech comes in to do the patient’s BP. Then you present to the resident, she comes with you and does another Hx and gives potential dx test costs before taking the patient back for further exams.

 

(Average Daily hours on duty?)

8AM-5:30PM

 

(What is the attire?  When do you change into scrubs?)

-First Day- One of the seniors told me this. “Usually, on ‘Receiving’ days, where you see appointments and greet the clients, you are supposed to wear business casual with a white coat. On ‘Surgery’ days, where you go to the OR or do procedures, you are supposed to wear scrubs with a white coat. Cardiology is mostly a “receiving” type of rotation, therefore ideally you should wear business casual with a white coat and deal with it if you get peed on.

-Doctors didn’t seem to care in this rotation/ didn’t bring it up

 

(What do doctors/residents/techs constantly harp on?)

-Know where to place the leads! For an Echocardiogram- “white on right” on right side (placed on the footpad) & “smoke over fire” where the black lead is on the left footpad of the forelimb and red on left footpad of the hindlimb

-ECG leads- placed distally to the elbow on both forelimbs are the “newspaper” leads (white on right & black on the left)/ placed distally to the stifles are “Christmas colors”. Patient is placed in right recumbency and the two leads placed on that side on the ground are “snow on the grass” (white on forelimb & green on the hind limb)

 

(What are some struggles to watch out for?)

-When tapping a patient during pericardial effusion, designate someone to always watch the ECG. Any sign of VPCs (ventricular premature complex) running in couplets, triplets, or more, inform the doctor (they will then inject lidocaine via IV). Patient can go into sudden V-tach and die! VERY IMPORTANT!

 

If you had the Cardio elective, keep the ECG sheets. They will give you another ECG packet to work on, so review them

 

(Words of encouragement)

-These doctors/residents/techs are wonderful! Super easygoing and chill. The material of the heart is dense, but they are great teachers who are patient and will do their best to help you get through it.

 

(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)

(1)- had 1 case a day, and sometimes had to pair up

 

Through Him!

~Camille

Psalm 34:8
“Taste and see that the LORD is good; blessed is the one who takes refuge in him”

 

Rate My Electives! (Year 3/ Spring)

Hey guys!

I can now officially say that I never will have to sit in a classroom and take an exam for the rest of my life!  What a feeling of invigoration and enjoyment.  Some say these past 3 years in vet school went by so fast, but they honestly have been long for me.  I love to try savor every moment of my life no matter how difficult it may be.

During the electives period, we did a dedication ceremony at UGA’s new Veterinary Medical Center.  It was well organized, and we had many Alumni and political officials come visit the site.

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Here are some pictures inside the hospital

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I learned a lot in the classroom, but I am now inching to experience what clinical rotations will be like.  Each three weeks, I will provide a synopsis for my time spent in a particular specialty here at UGA’s vet school or at one of my externships I signed up for.  My first rotation will be Cardiology, so look out for the next post soon.  Here are the reviews for this semesters electives.  Take care guys!

Electives (alphabetical order) Honest Feedback Overall Rating (1=NOT WORTH YOUR TIME!!! 5=Highly recommend it!)
Equine Imaging
good class! Learned quite a bit, although sometimes it could be a little boring. I even got to bring my horse in for a lab and got free radiographs on him! 5
Equine Respiratory
Not a horsey person but I did enjoy this class b/c its mostly Dr. Giguere. However, in retrospect if I had to drop one of my three classes I needed to take, this would be the one. I think respiratory in core really burnt me out. 3
Boring lectures in my opinion. Some of the information was new but a lot of it was review. Dr. Giguere has good intentions and is VERY nice, but I think he feels a bit trapped by the whole multiple choice testing system. Maybe he will branch out and do more clinical type testing in the future though! Probably a good class for horsey or mixed people to take anyway. 3
Equine Surgery
Good class, learned some new things and reviewed a lot which is good! Since there were so few people in the class, we had NO exams as long as we all had perfect attendance. 5
LA Cardiology   N/A
LA Neurology  N/A
LA Surgery
Great class. Very laid back atmosphere but super cool labs. There is one class, one lab, and one quiz per week, so the schedule is pretty easy. Classes are interesting and don’t waste your time at all. You get to do everything in labs with very little hand-holding. We did rectal exams, right flank omentopexys, and castrations on live animals plus enucleations on horse heads. Can be kind of scary but you learn a lot. Horse castration lab wasn’t super well organized, but it was still really cool. Quizzes are easy and graded generously. 5
Awesome class!! You get to work on live animals for several of the labs. There is no final exam and only easy quizes once a week. 5
Ruminant Digestive Disease  N/A
Ruminant Respiratory Disease  N/A
SA Cardiology
One of the best electives EVER. TAKE THIS. 5
This class is the jam. Great professors, useful material, etc etc etc. Can’t recommend it highly enough. 5
Do ECGs scare you? Do you want to get better at interpreting them? Take this class. There is a great ECG lab where you talk through interpretations and gain a lot of confidence. The tests are challenging but fair. 5
Great class! A lot of necessary information here that wasn’t discussed in core class. 5
Loved the material and the teachers. 5
The teachers are awesome!! As a person who cardiology has always been a difficult subject, I learned a lot! 4
SA Neurology
Really good review from core. Glad I took it. Both exams were really straight forward and I didnt put a lot of time in this class. 5
If you want a nice, laid back review from core b4 going on rotations, take this course 5
Teachers are interesting and fun. None of the scary neuro stuff you remember (or don’t remember) from freshman year. Lots of review but more focus on cases. 4
Kent and Platt are awesome. Material is very clinically applicable. 5
This class is very straight forward. You don’t have to stress about keeping up with the information because there is a review session before each test that summarizes everything you need to know. It is very clinically oriented so even if neuroanatomy was not your thing, don’t let that shy you away from this elective. 5
Great class! A lot of repeat from the core, but its so clinically applicable. 5
There were some repeat informtaion, but the practice localizing was great. 5
A lot of clinical cases. A repeat of core for the most part, but an easy class. Definitely improved my skills on localization. 5
SA Oncology
Required for taking Oncology rotation. I learned a lot from this course. You will see masses in practice on a regular bases, so I recommend taking the class to get a good foundation with cancer 4
Again, you must take this if you are planning to do the rotation. However, even if you aren’t, but will be doing anything small animal, I think this course is a must take. It gives you a good concept of how to approach lumps and bumps in general practice, when to refer and what diagnostic tests are required and which are just nice to have. 5
This ought to be a core course in my opinion. I know so much more about those lumps and bumps that come in every day now. There’s more complex stuff in the course too, but most of it is straightforward and important. 5
Somewhat tough, some of the material is very dense, but it’s also really useful if you’re going into GP. 4
This is a very valuable class and important if you are planning on doing small animal practice, but it is a lot of information and you do need to study. The tests rely more on clinical thinking than memorizing facts, so try to develop a clinical intuition about the process of diagnosing and the different steps you would take depending on the biologic behavior of each type of cancer. 4
Should be req. for SA people. Good class. 5
Useful information, sometimes hard to study for by yourself- so find a budy to talk over the differences between the tumors. :) 5

Through Him,

~Camille

2 Corinthians 8:11 “Now finish the work, so that your eager willingness to do it may be matched by your completion of it, according to your means.”

Finals Already!? (Spring Week 3)

Week’s Itinerary= Cardiology, Neurology, and Respiratory Disease Final Exams

The time has come for finals, and it is only the 3rd week of school!  I am still writing to you today, which means I survived through it all :)  I only had 2 finals this week, but I am also including my respiratory dz final that was taken the Monday after this week.

Even though I had to prepare for all of these exams, I decided to go to Florida to be a part of a Conference called by NAVC (North American Veterinary Community).  I highly recommend going to this conference at least once during your veterinary career.  Also while in Florida, I got to meet up with my best friend who lives in Florida and go to Islands of Adventures for a day.  It was a wonderful weekend!

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After all of this enjoyment, reality sets back in.  Time to focus!  My first final this week was Cardiology taken on Wednesday.  No midterm was given but only this final, which is 100% of my grade . . . scary thought.  I was nervous, but I still had total peace during my study time.  The information was more clinically relevant than the physiological approach from freshmen year.  My heart was pounding when I heard that the grades were posted, and I found out I got a B!  Thank you Lord!

Neurology was the next final taken on Friday.  It is so difficult to recharge and focus on another course right after taking an exam, but it had to be done.  Fortunately, one of the professors scheduled a review session the day before the final, and it greatly prepared me for the exam.  I strongly encourage going to the review.  I learned so much from that hour that will help me 10 years from now in practice.

Respiratory Dz was the very last final for my core semester.  I was so thrilled to almost be done yet very terrified because I needed to do well.  Fortunately, there were a little more questions provided instead of only 25 questions in the midterm.  Guys, after taking this final, joy bursted out from within me.  I am done taking core classes for the rest of my life!  Even though I have 2 more electives after this, my mind is now preparing itself for clinical rotations beginning in March.  I prayed about whether or not I should still write after each rotation, and I have decided that it will be beneficial to students after me to get a first-hand account for what goes on in the hospital.  Also, we are the first Class to go to the new hospital, so I believe it will be nice to share my experience in this new environment that no other student has been through yet.

Through Him,

~Camille

Habakkuk 2:1-2= “I will take my stand at my watchpost and station myself on the tower, and look out to see what he will say to me, and what I will answer concerning my complaint.  And the Lord answered me: “Write the vision; make it plain on tablets, so he may run who reads it.”

What a Surreal Week (Spring Week 2)

Week’s itinerary= Neurology and Respiratory Disease Midterms

This week has been one of the most surreal experiences of my life.  If anyone has ever taken midterms on the 2nd week of school, please have lunch with me so that we can discuss the insanity of it all.  The Neurology final was taken on Monday, and I actually thought the questions were fair for the most part.  Compared to freshmen year neurology course, this course is taught way better, and it is very engaging.  The test was about 30 questions multiple choice, and the last 4 questions were videos of dogs with various gait abnormalities where you have to decide where the lesion affects the central nervous system.

The format for the respiratory disease was a huge turn off for me.  Only 25 questions for an exam is not fair to me.  I really hope the final will not be this short.  I missed a couple of questions, which quickly brought my grade down.  Also, the material reminded me of taking bacteriology, virology, and parasitology class all over again.  Those were my least favorite classes I took in vet school because all I was doing was memorizing lists of diseases with their diagnostic tests and treatments.  Not a fan.

All right, next week is 2 finals, so I hope to survive this rigorous core semester.

Through Him,

~Camille

John 15:18-19= “If the world hates you, you know that it has hated Me before it hated you. “If you were of the world, the world would love its own; but because you are not of the world, but I chose you out of the world, because of this the world hates you

 

A Couple Weeks Until Rotations! (Spring Week 1)

Hey guys, welcome back!

In the last two years, we were forced to start spring semester on January 2nd while the rest of the UGA campus was deserted.  Now, we began our semester on Jan 5th with the undergraduates.  I appreciated this change very much because I got to spend a little more time with family.

I have never experienced a semester like what I am about to explain to you.  Our core semester will only be 3 WEEKS long!  I thought I went through all the thorny obstacles that vet school offers, but the academic coordinators trusts that we will succeed in these four courses in this short amount of time (Cardiology, Neurology, Practice Management, and Respiratory Diseases).

After these 3 weeks, we will have 5 weeks of electives and then the well-awaited rotations!  Rotations is where we will finally be able to go to the new vet school building and work one-on-one with doctors and assess clinical disorders on patients.  I really cannot wait!

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vet school construction

They have been working really hard.  This shot was taken in August 2014.  The site is looking more polished now.

I have to share a highlight this week that greatly touched me. I loved what one of the speakers in Practice Management said on Monday, “With $90,000 of student loans after graduating from vet school in the late 80s, I was able to pay off my loans within 4 years.”  YES!  I loved hearing that!  If you guys have not heard this before, I made it my mission and goal to pay off my loans within 5 years, and now I know it is possible to accomplish.  He is an inspiration to me.

Each day this week has been draining me because we would start at 8am and stay in the same room until around 4pm.  Having surgeries last year was a blessing for us because we could leave school most days around noon when it was not our assigned surgery day.  We will only have 2 more weeks of this, so I am not complaining at all.

I have 2 midterms next Monday and Thursday on Neurology and Respiratory Diseases, so I have to go prepare myself for the days to come!

Through Him,

~Camille

Psalm 34:8= “Taste and see that the LORD is good; blessed is the man who takes refuge in him.”