Four-Legged Lexis

Walking Discovery

I could not ask for a more perfect fall day.  Moderate temperatures, light breeze, smell of clean air, and almost no humidity.  The leaves have not started to change yet, but soon they will fade from green to warmer shades.  Did I write "fall" just a moment ago?  Uh yeah.  In the time since I've posted here, the seasons have changed, I've started a new rotation, and there have been some potentially big things happening.  And I had time to contemplate the events of the last week or so while Izzy and I took our first walk of any great distance tonight. 

For the rest of my rotation mates on the community practice rotation, the day ended early.  Our last appointment was at 2:45, and when it was completed, we did one more "rounds" session on behavior.  Behavior consulting is an area that interests me, and it's all a part of the client education that I am certainly passionate about now, and in a few months when I'm a doctor.   But alas, I had a patient to discharge, and the client arrived just minutes before 5:00 p.m.  I didn't mind staying because I was able to get a few other things done. 

The case that I dismissed was quite interesting.  It was relatively straight forward, but every time I see/do something for the first time, I give it the title of "interesting," "neat," or "cool," or some other such non-scientific exclamatory word.  It was a cat, one who if he were human might be considered "husky," with a swelling on his right ear.  I'd seen this lesion before - an aural hematoma - where the blood vessels in the pinna of the ear break form a blood-filled "pocket."  It's not terribly painful, or at least that's my conjecture.  Not having lived the life of a cat with an aural hematoma, I suppose I can't really say for sure.  In any case, the plan was simple.  Lance that thing with a scalpel blade, and drain all the blood from it.  Suture it in place.  And send the cat on his way, hematoma-less, vaccinated, and on the way to being flea free.  (Even writing about fleas makes me itch!)

It's been a while since I've picked up a scalpel blade, a needle holder, or anything semi-surgical.  So for a few moments, I had to think about how to place a "mattress" suture.  I was certainly a bit nervous about fixing the aural hematoma, even though I knew that a doctor would be there the whole time.  The doctor brought me some drugs to sedate the cat from the anesthesia area of the hospital.  I was hoping she would say it was a drug combo that I could give into the muscle, a fast, easy stick with the needle.  But in fact, it was into the vein.  I had no problem hitting the vein, but the cat didn't appreciate being stuck.  Little did he k now, there were more sharp things in his future.

I knew the sedation would not last long, so I had to be swift with my procedure.  I swiped the blade across the hematoma.  I didn't use enough pressure the first time, and had to do it a second and a third time to get the skin to open up.  It was quite satisfying when it did open up, as the blood spurted from the ear onto the towel tucked up and around the cat's head.  I continued to massage the ear, pushing the remaining blood out of the pocket.  About a minute later, the doctor showed me how to place the first suture.  My eyes followed her movement, in and down, then up, then down again, and up again, finally tying a knot.  And then it was my turn to repeat it on the opposite side of the incision.  My suture looked almost identical to hers, and that made me happy.  It  was so near-perfect that I almost wanted to put another happy face sticker on my name badge.  It would compliment the orange one that I stuck on there the other day for hitting a jugular vein on the first try. 

The cat's ear and head were bandaged.  He looked quite upset with us, but had no choice.  On top of having a bandage on his head that made him appear to have only one ear, he got a lampshade, too.  An e-collar.  And when I did discharge him to his owner, I gave the owner strict instructions that the collar should not come off, no matter if the cat whines, complains, and meows his discontent all night long.  And hopefully, the owner will show back up at the teaching hospital in a couple days for the recheck appointment. 

One More Step On the Path

Back in the Midwest, I found myself sick...again.  It started last week, a little bit of a cough.  By the time I stepped off the plane back on my side of the Rocky Mountains, though, it was a cough, sore throat, nasal congestion, headache, and general "icky" feeling.  I missed Monday and Tuesday of my last week of the radiology rotation, and had hoped to come back on Wednesday.  Overnight Tuesday into Wednesday, the cough worsened and was more concerning, and so I spent another day on the couch.  Through the beginning of the week, I had little to no voice too.  Knowing that my Grand Rounds presentation was fast approaching, I tried to speak as little as I could.  On Thursday, I was determined to get back onto the rotation, and have my time count toward my graduation requirements.  But, the cough persisted, and the section leader sent me home, with the agreement that I would not come in the next day either, and just make up the time later.  It didn't take much to convince me to go home, but I can't say that I wasn't a little bummed out about it.

At least during my time at home I had company.  Of course, the cats were here like always, but there's also "Izzy."  I've been mum about her on this blog up until now, except the small reference to missing "her" while I was in California last week.  Up until just yesterday, my parents, particularly my mom who reads this blog, had no idea that I had acquired a new four-legged friend.  Izzy has been living with my roommate and I now for 3 weeks.  Izzy is a mantle Great Dane, a gorgeous, smart, and personable pup, if I may say so.  You can look at the picture and see if you agree.

The plan was not to let out the secret until this morning.  I presented Grand Rounds today in front of the college community.  One of the last slides in the presentation is a "thank you" slide - offering a word or two about the different clinicians, professors, family, friends, etc. that have helped either in the presentation or along the way.  I thanked all the standard people and also "Izzy, Elly, and Zeus."  With the pictures of all three animals there, my parents would quickly figure out that there was a newbie in the apartment.  Up until yesterday, the times that I had spoken to my parents on the phone, she had either been quiet or I wasn't at home.  But just a day before the big reveal (sounds like a reality show ending, doesn't it?), a phone call to my mom went awry.  She wanted to play, and barked to tell me all about it.  And the next thing I heard  was, "What's that barking?"  I couldn't play it off.  There's nothing that sounds quite like a dog bark.  And so in a round about way, I admitted that I had a dog.  Not only a dog, but a soon-to-be VERY big dog.  It was not until today when I actually saw my parents that I told them it was a Great Dane.   

So being sick all week, I was very nervous about the presentation today.  It's such a big deal, a rite of passage of sorts, and certainly something on the imaginary check list of things that I have to do before I become a veterinarian.  I didn't want to screw it up.  I wanted a smooth, put together, smart, and informative presentation.  I started working on it at the beginning of August, but had postponed continued work on it until late August.  It was mostly done when I went to California, leaving only the references (I hate doing that) and adding in some pictures.  But, before Wednesday night of this week, I had not said the presentation out loud, only rehearsed it in the confines of my thoughts.   

Flight to Phoenix

I almost cried when I left her this morning.  Yes, her.  But the “her” does not mean I have changed any of my preferences.  And for now, that’s all I have to say about that.  The “her” isn’t important right now.

As I write, I’m sitting on a plane, en route to Phoenix.  And my final destination is back on the West Coast.  Maybe I procrastinated this morning because of “her” or maybe it was just that after being initially excited about the trip, now, I just have had a serious change of heart.  I suppose that even if I have rethought the idea of working in California after graduation, it will still be a nice vacation.  I still have friends out there, and the weather should be nice. 

Besides leaving “her,” I left him too.  Although we had plenty of time to spend with each other earlier in the week, BH and I couldn’t make our schedules match up again before I left to drive down to Kansas City this morning.  At one point in the planning of this westward bound excursion, he was going to take me to the airport.  He would drive my Jeep down, drive it back to my apartment parking lot, and then in a week, do it all over again to pick me up.  After the hurricane (and interestingly enough, both my rowmate on this plane and I had a hard time remembering exactly what day of the week the hurricane hit – if that says anything about the speed of either of our lives), gasoline prices spiked in Iowa, just like most of the country.  I took a picture of my receipt from last night’s fill-up.  I had a little left in the tank, and still spent over $40.00 at $3.09 a gallon to fill my Jeep.  It’s cheaper for me to drive myself down and back with a stay in economy parking.  I thought about him on the trip down, though, and wondered how he was doing on his own drive to visit his family.  He’ll be one of the first I call when I land safe and sound on the West Coast.

Radiology has been busy this week, at least after hours.  The actual days have had plenty of time to hold up the counter in between patients.  The after hours part only comes from my procrastination about writing up the film cases.  I don’t regret it for a second though.  Even the Wednesday night that I spent inside the depths of the teaching hospital, hiding in the radiology rounds room until 2 a.m. was worth it.  Earlier in the evening, BH and I had gone to dinner and spent some time together.  Life has to have priorities, and school is certainly important, but a larger priority of mine is “balance.”  And so far, in the short time that we’ve been figuring this all out, he’s brought some balance to my life. 

When I’m not spending time positioning patients and exposing them (and myself) to radiation or with him, I’ve been putting my thoughts and efforts toward my grand rounds presentation.  By the time I return from California, I’ll be just a few days away from giving it.  My parents are driving out to see me do this little twelve minute talk.  I’ve completed most of the presentation, but need to add some information on the drugs used to treat my patient when I arrive at the hotel tonight, if sleep does not wash over me first.  I just woke up from a little nap on the plane, so perhaps that will be good to get me through the next ten hours or so.  I know that during this trip though, I’ll be reciting and working on my delivery for this presentation.  It’s been a long time since I’ve given a formal presentation that I actually cared about, not really since my honors presentation four and a half years ago.  So mirror, mirror on the wall, listen to me, and anyone else I can find that might want to listen to a case study on acetaminophen toxicosis in a cat. 

The sunlight on the beach, I’ve found, does little for me being able to see the screen of my laptop.  So, working on the presentation on the beach is out.  But, I also brought along a stack of books to study for the board exam.  I can certainly take a few books with me to some comfy spot on the sand, maybe in Huntington Beach, and put in some hours there.  Perhaps I’ll even get some color on my skin.  It seems that getting that color via the artificial method is quite slow for my “super white girl” skin.  It’s very scary to think that it’s already September and that the exam is flying upon me faster than ever.  I wish I could have the ability to freeze time, just for a month or so, until I felt like I was more prepared.  My studying schedule of 50 questions a day sort of got thrown my the wayside during anesthesiology, but I need to redouble that effort, and start working through some of the other review books that I have on my shelves. 

And speaking of those shelves, I’ve added two more new books (like I needed any more).  Finally, after several years of anticipation, Greene’s Infectious Diseases of the Dog and Cat published as a new edition.  The new edition has a colorful cover, almost asking to be read and studied, unlike the previous green edition of Greene, which looked like a terribly boring read.  I will certainly reference it in the  coming weeks, as my medicine rotation starts the Monday after I present grand rounds.  And the other title is one that I said I wouldn’t buy until graduation.  But, in a conversation with “her” veterinarian, I discovered that the hospital had only a 2^nd edition of the Plumb’s Veterinary Drug Handbook.  The newest edition is the 5^th!  That’s a big jump.  So, with my super nifty SCAVMA Bookstore discount, I bought two copies of the book – one to put on my shelf, replacing my 4^th edition, and another to put on the veterinarian’s shelf, and compensate some money on my veterinary bill. 

I have no idea where in America I am right now, just that I’m flying above someplace more westerly than Iowa.  I don’t really care to know exactly, but I’m hoping that we’re approaching Phoenix soon.  I’m hungry…and I don’t see anyone pushing a trolley with those stale peanuts.  (Oh to fly Midwest Airlines with fresh chocolate chip cookies!)