Monday, April 30, 2007

kickin' ass and takin' names

i'm really super-duper proud of myself today. i diagnosed a sneaky little eye disease. of course, i was nearly bitten in the process (and badly), but i dodged the bullet this time. just a reminder that i REALLY need to get that rabies vaccination, especially considering that this dog had not been vaccinated for rabies recently. but that wasn't the point. this was a little blue heeler dog of indeterminate age and definitely determinate temperment (nasty). he had a history of an acute onset of cloudiness about 3 months ago in his left eye. his right eye was gone, but the current owner wasn't sure of the circumstances under which the eye was lost. they suspected trauma. at any rate, after nearly losing a hand to "chopper" - as i will affectionately refer to him, i muzzled the dog and preceded with my ophthal exam. i was thrilled when, upon examining the eye with a transilluminator, i saw what looked like the lens hanging out in the front of the eye.

now for a brief lesson in eye anatomy. everyone knows what the pupil is, right? the black spot in your eye, surrounded by the colored portion of the eye (the iris). well, the iris is actually a muscle surrounding that pupil, which is nothing more than an opening into the back of the eye that allows light in so that it can be detected by the retina. the lens, a basketball shaped clear object that is responsible for the refraction of light, sits back there. it's kept in place by thousands of tight little - for lack of a better word - pseudo-ligaments - called zonules. sometimes these rupture. there are a variety of causes, the most common being an inherited defect, as seen in jack russell terriers. glaucoma (increased pressure in the eye) can also cause this, as can trauma to the head (less frequently). at any rate, when i first looked in the dog's cornea (the clear part at the front of the eye/where you put your contact lens), i was 100% sure i saw the lens in front of the pupil. this represents a total luxation, where all the zonules are broken, and the lens has floated forward into the anterior chamber of the eye. i was SO excited. for my diagnosis, not so much for the dog. when the lens comes forward into the eye, it blocks a crucial angle that exists more or less solely for the purpose of draining aqueous humor (the fluid in your eye - NOT tears). when that angle is blocked, the aqueous can't get out and pressures in the eye begin to rise, leading to glaucoma. when i measured this dog's pressure, it was definitely elevated (normal is 15-25mmHg, this dog had 33mmHg). the 2nd time i looked, i had a harder time seeing the lens. after all, in a normal, cataract-free eye, the lens is crystal clear - and really hard to see, even when it's misplaced.

the doctor came and examined the dog and confirmed my diagnosis. i swelled up like a japanese blowfish, i swear to god. i was so happy to make such a definitive (and to me) difficult diagnosis. so our recommendation for this poor dog (already blind on the right side due to -- well -- not having an eye and all) was that the owner take him home, try to bring down the pressure in that eye with glaucoma medications, and that the eye be dilated with mydriatic drugs (tropicamide) to encourage the lens to fall back into the posterior chamber behind the lens (it poses less of a threat there to vision, although it still ain't good). the other option was surgery to remove the lens, but with the problem lasting 3 months already, and the pressure in the eye elevated, and the dog already experiencing visual deficits in that eye, it is unlikely that the dog will have restoration of vision (10-15% chance). he's already lost some, so the probability of ever being even 50% visual in that eye is very, very poor. those are not great odds for a surgery that costs $1000.

the owner elected medical therapy, and we sent "chopper" - the first dog to nearly take my hand off, home. he was quite the patient. we had to muzzle him to do a proper ophtho exam. it was not fun. well, the part about being right was. the rest wasn't. a cat also tried to bite me today. i must taste particularly yummy...

Sunday, April 29, 2007

brave new world

my first week of clinics is officially over. and i LOVE it. and i mean LOVE it, as in i worked from 7:30am to 11:30pm on wednesday, and i didn't give a damn that i was at school for (umm..doing mental math) 16 hours straight. i was so happy. still am. and i'm motivated, i'm sleeping better, and i just feel good. besides working emergency on wednesday, i was at school from 7:30-6:30 every other day. we've been moderately busy in the 'ole ophthalmology ward. the time flies though, i never look at the clock and lament how slow the day is going by. that must be a good sign, right??

despite working 11+ hour days, i came home every night and studied, studied, studied. hematology, ophtho, neuro, you name it, i've been cracking the books on it. for a change - i WANT to study. i WANT to learn and understand and be good at what i'm doing.

it paid off on friday. we had a mid-way through our rotation evaluation with the clinician overseeing us. he had nothing but the highest praise for me - in fact, he actually said that i was so far above average, it was phenomenal. yes, a clinician described me as phenomenal. i was intensely gratified. and yes, my ego swelled a bit, i'lll admit it.

so, i could talk about the cool stuff i saw this week - including a dog brought in on emergency because it was hit by a car (turned out to have a diaphragmatic hernia). however, i'll save that stuff for a later date, when i'm not tired and a hair cranky.

to wrap up - i LOVE clinics. i feel like i'm going to really thrive in this environment. it's going to be a great year.

Sunday, April 22, 2007

in 3 years, what have i learned?

it is 12:06am on the day i begin clinics, my fourth and final year of veterinary medicine. hopefully, the end of my formal education (though i hope to continue learning until i die). i've spent the day more or less productively. last minute shopping at wal-mart, getting those small things that i keep forgetting i need until i need them, puttering around and cleaning the house, laundry, vacuuming furniture, collecting fur and featherballs and the like. reading a bit (cormac mccarthy's book, the road) and napping. i spent the latter part of this evening reviewing ophtho notes, hoping to be as prepared as possible for tomorrow and the start of my year as a fake doctor (preceding, i think, many years as a real doctor). all day, thoughts have been percolating in the back of my head - thoughts on what i've learned in the past 3 years (besides a heckuva lot of veterinary medicine).

what i've learned is that the most important things in life are not things at all. they are people. more specifically, the people that i grew up with- that raised me. i mean my family, of course - but also my husband. we started dating when i was 17. we've now begin together for 10 years of my life. since i'm not yet 30, that amounts to greater than a third of my life. where and who would i be without his formative influence? we truly grew up together.

i have him, my husband and best friend. i have my family too - always supportive if sometimes in oblique ways, always with me.

i learned in the past 3 years that what people think and say about you carries very little true importance. at the time, it may hurt, it may worry you, but all of those feelings and hurts fade with time. even the feelings that were wonderful are fleeting. everything fades into the grey of the past. as a result, we must hold on very tightly to those things that are true, to those people that are true. the rest should and will fall by the wayside.

it took me a long time to come to the acceptance of the inherent nature of people, especially groups of people. i still struggle with it now. but, in the last few weeks, it has become abundantly clear to me that worrying about what other people think, what other people do is unimportant. we get so bogged down, everyday, in the mundanity of the world, in the pettiness of unhappy people. and that leads to our inevitable unhappiness. it is only by separating ourselves from those unhappinesses that we can begin to become happy ourselves. it sounds touchy feely and new age-y, i realize. but it's so true. surround yourself with unhappiness and misery, and you will find yourself wallowing in it. surround yourself with love and happiness, and your life will follow accordingly.

i can't believe i'm a fourth year vet student. everyone said it would come quickly, and i knew it would. i know that time passes like a sigh. and i know that this year will pass too quickly, as all years do.

i'm not even nervous or frightened. i'm ready. i'm smart, i've worked hard, and i love that i'm going to be a veterinarian. i have my family, my husband, my best friend, the love of more people than i know what to do with or deserve, and i'm on the path to my future. why shouldn't i be happy?

Wednesday, April 18, 2007

monday comes too soon (maybe)

i don't think that's actually true. mentally, i may not be ready - but the longing to be finished with classes is so strong, it overrides any feelings of inadequacy and unpreparedness that i may (do) have. any rate, monday heralds the beginning of my final, clinical year at the good 'ole VTH. it's almost incomprehensible to me. further evidence that the passage of time can seem like the movement of molasses and the speed of light, all at one time. how can i be almost 28 years old? married for almost 10 years? entering my FINAL year of graduate school, shortly about to begin a real life that involves a professional career, finances, 401Ks, employees? how can i be ready to have people report to me? look to me for answers? trust me with the lives of their beloved pets and family members??

ack! so much to ponder. maybe i should ponder my way over to my ophthalmology book so that i won't look like a complete dunce come monday and my ophtho rotation. which is a GREAT rotation to start with, because i love eyes, i love the ophtho clinicians, and it's lower stress than other rotations. a good place to get my bearings...

Friday, April 13, 2007

*sigh* here i am again, and why the long face?

you'd think i'd be happy. i'm finished forever with final exams, with 8 hours a day of lecture followed by 4 hours a night of studying. all that's over and done with - finito, as i said...but the vet school, in all its infinite wisdom, has seen fit to give us not one but two weeks of accreditation and transfer seminars. yup, instead of giving us a break between now and the beginning of the end literally and figuratively - we have to sit in a dark, smelly, windowless classroom for the next week (as the previous week is FINALLY over) and listen to lecture after lecture after lecture on foreign animal diseases, federal veterinarians, our role as private practitioners, and on and on. next week will be filled with lectures on how to negotiate for a job, how to negotiate a contract, and other business stuff. 2 weeks of this - 8-5 every single freaking day. it's been god awful. and it's not just sitting there, either. we have assignments, too. in fact, the day after my last final exam, we had to give group presentations. not all of us, mind you - just the 5 groups unlucky enough to be picked to go that first day (mine included, of course). so instead of coming home from my derm exam and the BBQ that i organized and implemented for 200 people, i came home and frantically worked on my powerpoint presentation. it was GREEEEEEEEEEEEEAT! as tony the tiger would say. the next day, after the presentation was over, and the excruciating 8 hours of lecture done with, i came home and fell asleep for 14 hours straight (till the next morning, obviously).

so, anyway. yeah, finals are over. i don't know any of my grades. i went into finals with all As, and i think i'll come out with all Bs. but who cares? it's over. at least that part of it is. i'm apprehensive about clinics -but i guess everyone is. or maybe most of us are just ready - so ready - to be there...and to be out and having a real life. i'm so ready to be away from the vet school i can taste it like an oil on my tongue. that taste that coffee leaves in your mouth, long after the coffee is gone.

my mom called me tonight from outback. she was there with all my brothers, save john, their girlfriends, and my dad. it sounded fun. it made me sad that i wasn't there. i feel so far away from them sometime. but i'm here - and i have so much to do...

i will never eat french fries or go to hooter's on a friday night again

you might wonder what those 2 things have to do with one another...and you would be right to do so. tonight was the 3rd annual 'eat for elephants' contest. our class has organized and hosted it every year. the last 2 years were a chicken nugget and hot dog eating contest, respectively. this year, our VP went crazy and got hooters to let us have it there. it was an eating relay - in which teams of 3 had to eat fries, wings, and key lime pie.

i've never eaten food that fast. ever in my life. it's revolting. stuffing down cold, congealed, hard curly fries by the handful and chasing it with water - god, it ws horrid. i was the first to go on the team, and i had to eat a huge bowl of fries. i didn't think it'd be a problem at all - i LOVE french fries. when they're hot and fresh. NOT when they've been sitting in a bowl, congealing in their own grease for 45 minutes. i can't begin to tell you how disgusting it was. i get nauseated thinking about it. i'll never eat french fries again (chyeah, right). at the end, the french fries started to come back up. i had to take a breather for a moment, so that i could get my bearings. but i got them all down. and i won for that part of the relay. unfortunately , we fell behind in the wing eating department. then alisha swooped in and inhaled 2 pieces of key lime in about a minute and a half - no exaggeration. it was unreal. but we still came in 2nd, with the loser 2nd years beating us out :(

of course, i will be posting pictures of this disgusting-ness that constituted my friday night. but only when i switch to my desktop.

Friday, April 6, 2007

3 down, 1 to go

i'm finished with all but 1 final. FOREVER. no more after this. i am finished with sitting on my butt all day and studying. it's an exciting thought.

thursday's test, large animal orthopedics, specifically cow feet - was a raping and then some. but oh well. i had middling A (94) going into the exam. i'll be pleased to get out of the class with a B. i'm pretty sure i tanked on it. i reached some sort of mental wall, and i couldn't get around it. normally, if i take my time on a test, recheck my answers, and just kind of sit - the answers will come to me. i always have faith that the answers are there, in my brain. this time, i just ....... couldn't ....... think. it was like trying to slog through 8 inches of mental mud. i actually threw up my hands during the practical portion and turned my test in without fixing an answer i knew to be wrong. i guess you could say i'm finished. no more. finito. stick a fork in me, i'm done. it's clinics for me, and then no more school forever. of course, i say that now. but watch, in 6 years, i'll be considering a phD. i'm a sick, sick person.

Tuesday, April 3, 2007

what i am doing? i'll give you one guess.

i bet you didn't guess sitting at my computer, listening to rogue wave, and studying. ok, so you probably got the computer and studying part - but come on, the rogue wave was outta left field, right?!?

i would bitch about how awful my day was - and NOT as a result of studying - but it would be so whiny. ok ok, i'll do it anyway. university policy states that there are to be no classes in the 2 days prior to exams. right-o? pretty much a universal rule - colleges, state schools, everybody in higher education agrees on this. except - apparently - the magical world of the veterinary school. yeah, we had 6 hours today (from 8-2 WITHOUT a lunch break) in which we were introduced to the heads of all the departments and given STACKS of manuals, paperwork, and information about our shortly to begin 4th, final, and clinical year. now, this information would ordinarily be helpful and somewhat exciting to receive - heralding the start of the last year i will have to sacrifice my life for my education. except it comes the day before 3 finals - all comprehensive. now, on top of that, i have mindnumbing PMS for which i cannot find a satisfactory cure. i actually came home and slept for 3 hours before commencing my studies (an unprecedented occurrence the day before a FINAL exam, the material for which i have not completely covered, nor did i attend all (or even most) of the lectures).

SOOOOOOOO. here i sit, at 12am - with several more hours of small animal ortho to finish...before i can even think of trying to sleep (if my coffee-addled brain will even allow such a thing). **Sigh** they also managed to pile on us (today) a massive list of stuff we have to accomplish soon - including getting my stupid rabies vax - which i should have had long ago anyway and for which i now have to cough up $500 or so. as if my to-do lists aren't already pages and pages and pages and pages long (and pages) (and pages.). a small summary would include buying comfortable but dressy pants for clinics, ordering the special crocs in ballet flats instead of ugly old clogs, getting an RX for my allergies before they off me (the allergies, that is - or the pollen maybe), getting my car tag renewed (expired 2 months), geting a new contact RX (been wearing the same 2 out of date contacts for at LEAST a month, if not more), registering to take the NAVLE and getting fingerprinted (yeah, we have to get fingerprinted - i know - WHAT?), and on and on and on. plus i'm out of things like razors, shaving cream, and detergent. but who has time for that crap anyway?