Everything comes in threes.

So this weekend was a little bit of a nightmare. And by weekend, I mean Monday also, because the horribleness extended into last night as well.

Saturday night, a really painful impaction colic with displacement of the colon comes in. Owner can't really pay for surgery even though it's necessary, so the attending and intern agree that medical management can be tried overnight. Well, that night this horse proceeded to kink it's IV catheter and pull out the fluid line (there goes 20 litres of LRS) because he was rolling in pain. Let me say first that this horse was on a substantial amount of pain medication and sedation to try and make him comfortable. At 4am, I was the first one down to check on this horse. Fluid line was wrapped around his front leg and was pretty much destroyed, another 20 liters of LRS in the shavings. Not my happiest moment. We manage to salvage the IV catheter, but have to replace the fluids and the IV fluid line. Put him on more pain medication. Next morning (Sunday), things are as bad as the night before and the owner decides to call it (after a thorough explanation about how he might not make it through surgery even if we decide that is the path, etc). Really sad.

Sunday night, as the other extern and I are getting ready to go downstairs for midnight treatments and we see a trailer drive by our bedroom window. Didn't get any heads up from the intern on call, so we wander downstairs to see what's up. Unexpected colic case walks through the door. Come to find out that their referring vet had called another emergency clinic and expected them to go there even though they said they were coming to us. Frustrating, but obviously not going to turn them away because of it. Another horrible no good colic which, after an hour of workup, the owner decides to euthanize because surgery isn't an option. Another sad ending.

Monday goes well, lots of appointments to see and lots to do. Get told around 4pm about an emergency colic coming in around 6:30-7pm. 2500lb+ Belgian with a colon torsion. Sigh. Surgery not an option, due to the size of the animal and all the complications that can occur. Also, high possibility that the colon will rupture as it's being moved onto the table. Ok.

6:30pm rolls around and this giant horse walks through the door, full of sweat and obviously in a lot of pain. Two nice guys from Maine are handling him and explain what the deal is. Intern on call starts the work-up while the attending vet is handling some important paperwork. One of the vet techs stays to help (superstar). Intern gives him some sedation and pain meds, but they don't have an effect. Really super bad sign. Also, this horse is huge and in a lot of pain and not really paying a whole lot of attention to anything (not surprisingly) so being around him alone is scary as sh*t. I won't sugarcoat this. Working up an animal this large and this unaware is terrifying. The intern (also a superstar) did her best. Attending comes in and takes one look at the horse and is basically telling the handlers (the owner wasn't present) that the horse is dying. Because he is. I saw this horse's gums - they were white as a sheet. As the attending goes to try to place a catheter for the third time, the horse starts to collapse.

Now, when a horse like this collapses, it doesn't get up. Period. That is the awful truth. And it was awful. I've never seen an animal die like this in front of me, but everything is a learning experience. Thankfully everyone there was smart and stayed safe when he started to go down, but it was really scary to see it.

For all those people who are thinking "why didn't they do more?"

Well. I have to say that it was handled in the best way it possibly could be handled. These situations are never easy, and it's very hard to make sure everything goes smoothly. Unfortunately, the horse should probably have been euthanized instead of traveling 3 or 4 hours to get to this referral clinic. But he wasn't. He also should have gotten an IV catheter placed by the referring vet and gotten a bolus of fluids and pain meds before traveling, but he didn't. By the time he got to us, he was so dehydrated that an IV catheter was impossible to place. It was an upsetting situation that no one could really have changed that late in the game.

I'm just happy this horse's suffering didn't go on for too long after he arrived. The whole thing was over in about 20 minutes, even though it felt like much longer.

Anyway, these things happen in threes, right? So fingers crossed the next emergency colic cases that come in have happier endings.

Here's a picture of my kitten to make this post less depressing.

Sleepless in NH.

I'm fairly certain that sleep deprivation has the same effects as excessive drinking. Because I feel drunk even though I've not had a drop of alcohol in about 3 days, but I've had about 3 hours sleep since arriving at my placement yesterday afternoon.

So in the past 48 hours, I've had a whopping total of 7 hours sleep thanks to jet lag and a surgical colic. Suffice it to say that I'm not only tired, but in that giddy, silly phase of overtired. There are 2 other externs here with me, and basically we're all in the same boat, so it's been a fun time.

And now, to bed. Because I'm on call tonight for emergencies and I have a funny feeling the horses won't let me sleep.

Back in the USA

So glad to be back in the US! Just flew in this afternoon (US time). Had a great time at Abattoir (and passed it), and had a wonderful week up north in Lancashire. Even did part of a caesarian section on a sheep!!

And now, I'm so jet-lagged and all I want to do is sleep. Except I can't, because then I'll just wake up super early.

Tomorrow, I'm off to New Hampshire to start my next clinical placement. Can't wait!

First Rotation: check.

I finished my Anesthesia rotation on Friday. I'm still in shock that my first rotation is over. It still feels like if I pinch myself too hard I'll be back in year one sitting in a lecture hall in Camden. How am I in my 'final' year at RVC?

Anyway, Anesthesia was pretty amazing. Really difficult, but really rewarding. Everyone in that department is great, super helpful, and tries to make every moment into a learning opportunity. My first week was great, but I realized how much of the knowledge I was missing within the first couple of days. But if anyone asks me again about the systemic effects of medetomidine, I will be able to answer it fully instead of just muttering "sedation, analgesia, bradycardia?".

I'm second on call tonight, so I suppose I'm not 100% done with the rotation. We'll see if it's a crazy night.

This week, I'm off to Bristol to do my Abattoir rotation. Since we don't have one here, the RVC sends us to University of Bristol to complete our one week requirement. Short days, near the ocean...I don't think I'll complain too much!

I'm also a week out from going back up to Lancashire for a week, and then jetting back here to pack up to leave on March 9 for Boston. I'm not really giving myself any time to sleep for the next couple of weeks...

Anesthesia is pretty awesome.

I'm exhausted and having so much fun.

Rotations are hard, but really rewarding. I really love being in an animal hospital again and actually interacting with animals on a daily basis.

Now, back to reading up about anesthetic agents.

3 Days til R-Day

Rotations start on Monday. I've been doing the frantic "Do I have everything?" dance for the past two days now. This morning I got out all of my business casual clothing to make sure I had enough. Really, I could use a couple of 3/4 sleeve sweaters. And maybe a pair of comfy shoes. And a thermometer.

Also, I've been worrying over what I'll have time to cook at night. Now that the house has a new freezer (courtesy of my endless searching and emailing on gumtree), I can freeze more stuff to take in as lunches instead of eating peanut butter and an apple for lunch. Trust me. It's a lovely snack, but as lunch? Not so much.

And my kitty. I adopted a kitten (practically an adult) over the Christmas holiday and I've named him Rory. He's adorable, slightly destructive (slowly getting him out of that habit), and he's been completely spoiled since I've been home 24/7 for the past two weeks.

Hell, I'VE been completely spoiled. Getting up on Monday is going to SUCK. And simultaneously be awesome.

Research research research.

I had my wonderful holiday in Tenerife with my friend A last week (got back last Sunday). It was paradise, it was lovely, and we had a really great time hanging out and relaxing in the sunshine (and getting sun-burnt in the process).

But now I'm back to the reality that yes, rotations start next week and yes, I need to get a good portion of the prep work on my research project done this week. And I also need to start getting up earlier than 10am and going to bed earlier than 2am.

For now, I'm going to enjoy the rest of this time off as much as possible. Because after this, there's not a whole lot of time before real life has to start.