Orthopedic Surgery

Performing surgeries on bones are so different from soft tissue surgeries, but it was still really fun to watch. I can picture men flocking for this specialty because there are so many hardware tools to work with (nails, pins, screws, hammers, saws, wires, etc.). I was very bias though with this thought before starting this rotation because I was with two female veterinarians who were on FIRE and were powerhouses with these surgeries! They could do everything effortlessly an sometimes even better than some male veterinarians I worked with. These surgeries were not as diverse as soft tissue surgeries were though. The majority of cases were TPLO (tibial plateau leveling osteotomy) operations to help stabilize the knees of a pet and fracture repairs. Other occasionally performed surgeries included patella or “knee cap” stabilization and repairs of tendon tears. Overall, it was a very interesting rotation but with very long hours.

 
Here’s what other people had to say about this rotation:
What was Orientation Day like?
-Very short orientation
-Super short orientation, went straight to work!

 
Average Daily Hours on Duty?
-expect 7-7 depending on which clinician it is
-6:45AM-8PM for our clinician, we had long patient and topic rounds

 
What is the attire? (When do you change into scrubs?)
-scrubs or dressy for receiving patients (tues and thur). scrubs (will change into clean scrubs immediately before surgery, so bring extra pairs) on surgery days, mon, wed, and fri
-Scrubs or dress clothing – I wore scrubs for sx (surgery) days and dress clothing for receiving days

 
What do doctors/residents/techs constantly harp on?
-Use slings, write clear notes on treatment sheets so others know they must use a sling/ cart patient!

 
What are some struggles to watch out for?
-Physically demanding

 
Words of encouragement (positive comments/stories during your time in this rotation)
-may get to use some power tools in surgery, placing screws!!
-Placing screws and drilling holes was so awesome! Made all the work well worth it!

 
Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload
-2 out of 3
-3 – had few people on block (the less people, the more work!)

 
Through Him,
~Camille
Matthew 11:28= “Come to me, all who labor and are heavy laden, and I will give you rest.”

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Ophthalmology Rotation

Whenever I am learning about the eye, I am always so captivated and in awe of how beautifully and intricately God made us.  I appreciate new discoveries by scientists.  Their findings give me a more behind the scenes view of God’s masterful work.  Thank you!
 
Ophthalmology rotation was a busy rotation, but it was not severely difficult.  I was constantly on my feet seeing the next patient, but our physical exams mainly honed in on the eye using sophisticated tools that would determine the pet’s current eye defect.  My favorite task was dilating the pupil and shining a light through a lens in order to see the retina.  It is a beautiful anatomical structure found in the back of the eye.  After you do a thorough eye exam, then the resident comes in and does their exam but with more advanced equipment.  After the resident looks at the eye, then the faculty ophthalmologist assesses the eye.
 
We also had the wonderful opportunity to observe surgeries performed on eyes.  My favorite surgery was a phacoemulsification, which is a modern version of cataract surgery where the lens are removed through emulsion with an ultrasonic hand piece.
 
Here’s what other people had to say about this rotation:
What was Orientation Day like?
-Arrived at 8:00 and briefly went over what to expect during the rotation.  Looked at the schedule for the day and started seeing appointments like normal.
 
Average Daily Hours on Duty?
-8:00-9:00 to 4:45-5:30
 
What is the attire? (When do you change into scrubs?)
-business casual with white coat and nametag; bring scrubs in case of emergency surgeries
What do doctors/residents/techs constantly harp on?
-know your drugs, how to do a basic exam, etc.  nothing is harped on and they are happy to teach easy basic stuff, but you could review a little
 
What are some struggles to watch out for?
-Appointments take forever.  I would recommend just setting your clients up for a long process in the beginning by explaining how the teaching hospital works and that things move slowly.  Most clients are pretty reasonable about it, especially if they know ahead of time.
 
Words of encouragement (positive comments/stories during your time in this rotation)
-Super nice doctors.  Rounds are helpful and consults from other departments are good opportunities to learn about the basic exam.
 
Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload
1 / 3
Through Him,
 
~Camille
 
Philippians 4:11-13= “Not that I am speaking of being in need, for I have learned in whatever situation I am to be content. I know how to be brought low, and I know how to abound. In any and every circumstance, I have learned the secret of facing plenty and hunger, abundance and need. I can do all things through him who strengthens me.”

Soft Tissue Surgery Rotation

My love for surgery has been solidified after taking this rotation.  I was fascinated every day.  If you do not mind the presence of blood or having to stand up for a couple hours, then you will be fine on this rotation.  Whenever I watch a surgery, it feels as if I am watching a play and want to clap my hands once the surgeons have completed their procedure.  I also liked how the rotation was organized.  Instead of having to see clients every day of the week, we only get appointments on Monday and Wednesdays while surgery days are on Tuesday, Thursday, and Friday.  The round topics were also very helpful for my career path.  I used to want to pursue a specialty in surgery but later decided to go to private practice.  I was very encouraged to learn that there are still a lot of surgeries I can perform without having to specialize in surgery.

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

(What was Orientation Day like?)

-Tech, John, did our orientation. Semi-organized… Appointments start at 10am and then go time.

(Average Daily hours on duty?)

-7am (earlier if have more than 1 patient) – 6:45pm-8:15pm (depending on when rounds get done in the afternoon, whether you have the last surgery of the day, and how complicated your in house cases are….)

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

-Always have clean scrubs available. Never know when you’ll need to go into surgery. Can wear scrubs every day. Recieving days Monday and Wednesday (professional attire recommended). Technically on surgery days (Tues/Th/Fri) can wear whatever in the morning to do treatments and then change into scrubs for surgeries.


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

-We had a nice group… I guess harped on would be attendance in surgery suite – even when not your own surgery. They want students to be present and not just hanging out (working) in rounds room while surgeries are occurring.

(What are some struggles to watch out for?)

-Long Days, Short nights (ie very little free time). Week-ends you tend to be there until 9 or 10 am depending on if your in-patient is simple or complex.

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

-2

Through Him!

~Camille

Proverbs 3:1-5 

“My son, do not forget my teaching,
    but let your heart keep my commandments,
for length of days and years of life
    and peace they will add to you.

Let not steadfast love and faithfulness forsake you;
    bind them around your neck;
    write them on the tablet of your heart.
So you will find favor and good success[a]
    in the sight of God and man.

Trust in the Lord with all your heart,
    and do not lean on your own understanding.”

Neurology Rotation

I learned so much in this Neurology, but it was by far one of the most grueling, exhausting rotations I have taken.  Part of this is primarily due to the lack of students in our block (4 total).  We had patients come in everyday for appointments plus emergency transfers, so you can imagine how busy it can get.  I definitely don’t recommend taking this rotation right before NAVLE examination (National Board of Veterinary Medical Examiners), but do take it some time before taking the exam.

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

(What was Orientation Day like?)

-We had a lot of cases already the first day, so we got to work at 10AM.

(Average Daily hours on duty?)

7:30-6+ (usually got done by 6:30-7:00 pm)

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

-wear nice clothes and a white coat. Bring clean scrubs to change into if needed


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

-KNOW where to localize the lesion.  You will get a lot of practice.

(What are some struggles to watch out for?)

-Take care of your back.  You have to bend over and pick up patients a lot in this rotation.  Bend your knees!

(Words of encouragement)

-Once you are comfortable with localizing the lesion, you are more comfortable with tackling a case.

-It’s usually the same process.  MRI, +/-surgery, NSAIDs, and cage rest 😛  Of course there is more to this, but you begin to see patterns.

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

-3

Through Him!

~Camille

Proverbs 3:26  “for the LORD will be your confidence and will keep your foot from being caught.”

Pathology Rotation

Sorry for the hiatus guys!  Before taking this rotation, I heard that it is one of the easiest, most laid back rotation of your final year.  They were absolutely right plus I learned a ton of very valuable information.  I encourage taking this rotation after a busy, long-hour type rotation or during the time you are really studying hard for the NAVLE examination (National Boards of Medical Examiners).  You get to sleep in (does not begin until 10AM), and you do not have to worry about taking care of inpatients or discharges.  The only documentation you have to do are necropsy reports that take an hour of your time at most.  There are also 2 quizzes and one group project.

Two areas of pathology that we focused on were necropsy and clinical pathology.  The clinical pathology portion occurs first in the morning followed by necropsy for the afternoon.  Depending on how many animals get dropped off for necropsy, we usually leave at 4-5pm.  I was a little nervous for the clinical pathology portion because I struggle with that course during my 2nd year in vet school.  After the first day of rotation, I was so thrilled how much I remembered from class!  That is the best part I love about clinical rotations.  You get the opportunity to reinforce what you learned and begin applying the knowledge to real life scenarios.  I also loved how we get to see the underlying cause of the animal’s death.  Sometimes, owners may not have enough money to pursue further diagnostic tests to diagnose the disease that is causing the pet’s clinical signs.  Even though we may not see the problem grossly, further diagnostics such as histopathology, infectious disease panels, and other tests will help us get the diagnosis.  In addition, over 90% of the cases you see in clinics involves Complete Blood Count (CBC) and Chemistry, so I strongly encourage that you make flashcards of what cause discrepancies of the cells and electrolytes (ex: decreased RBCs is anemia due to blood loss or lysis (death), elevated sodium (Na) could mean dehydration, a prolonged fever, excess intake, hyperaldosteronism, etc.)

Necropsy was enlightening.  There were many gross moments, but the findings were worth the process.  One case was particularly out of the ordinary that I had to dissect and remove organs from.  An armadillo was shot in his cervical (neck) area.  The reason it was brought to the school was because the person got some blood splattered in the eye, and he was afraid he was going to get leprosy.  Armadillos are naturally infected with Hansen’s disease (leprosy), but very rarely will people get leprosy from an armadillo, but our job was too confirm if the armadillo had it or not in order to make the pedestrian feel more at ease.

Overall, this rotation was absolutely wonderful.  Make sure to put “Vicks Vapor Rub” under your nose when you know something putrid is coming in for necropsy 🙂

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

(What was Orientation Day like?)

-Orientation at 8:30 in the room by necropsy going over procedures and touring clin path. We got about 2 hours for lunch and had to be back for necropsy at 1. Change into their scrubs before then (they provide scrubs and boots, you bring gloves). Meet in the same room and divide up the cases for the day. Fill out the pre-necropsy part of the form think through what differentials you have and what samples and test you want to run. You watch a pathologist do a necropsy then dive into the case load for the day. We happened to have 6 cases so we were there til 8 but it depends on case load.

(Average Daily hours on duty?)

usually 10-12ish for clinpath in the morning, necropsy 1-? depends entirely on case load. The day we had no necropsies we had to check in every half hour til 4.

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

-anything in the morning, change into their scrubs in the afternoon

-scrubs and boots in afternoon were provided = great!

-anything in the morning, scrubs and boots in the afternoon are provided.


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

-Use appropriate terms and past-tense in path reports

-describe what you see–>don’t need to try to make things more difficult. Just say lungs were heavy and firm instead of “pulmonary edema”.

(What are some struggles to watch out for?)

-The smells! Wear a mask and put vick’s inside it (theres 3 containers of it in the necropsy room)

(Words of encouragement)

-Brought snacks and cold drinks to the path break room- was so nice to have them when working on reports at the end! Also, necropsy was really cool – really neat to see all of the different animals

-They don’t expect you to know everything! Ask tons of questions. Bring your computers/ipads and leave your valuables in the necropsy writing room NOT the locker rooms. Use your computers to look up differentials for your cases and to start your report then. Many times the necropsy form will say “puppy acute death” with no other details. So trying to think of all the viral, baterial, fungal and congenital causes for an acute death in a puppy is easier when you have Dr. google:) For the first 2 weeks, you can type your necropsy report and send it to the resident later. The third week you stay there and write it.

Through Him!

~Camille

John 14:27  “Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be

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.”