Self diagnosis

So the question is what exactly brought on persistent cramps today? My bet is on a combination of raw carrots and iron supplement, on top of my GI tract's general disgruntlement with the world ever since I forced metronidazole on it. However, the reuben sandwich (with extra sauerkraut) and coleslaw may have also acted as predisposing forces. Starting last night and continuing all of today, I've been doubling over every couple of minutes with a fresh round of abdominal pain. I'd been a bit tender in increasing increments after Wednesday's endoscopy, but this is actual pain.

And it's exhausting. It's a good thing our winter break goes for three weeks, because I can't imagine how I would handle classes on top of this. As it is, I don't see a way I can keep up the surgery tech job. Sometimes I feel fine (well, not this week so much, actually). But it's so unpredictable, I don't think there's any way I could ensure I'd be able to work any given night. I know that there's never a way to guarantee you won't come down with a stomach bug on a day you have to work, but I think you can usually count on not having that problem a routine basis.

My hope is that with meds and very careful eating, I won't have this set of problems during school. Even if I do, there's a trance-like quality to studying which can cover up minor discomfort.

I find it interesting that I am much less resistant to the idea of starting meds before seeing the doctor once I'm actually in pain. "Gimme anything that'll help!"

Hopefully the copious amounts of gatorade, pepto bismol, and avoidance of carrots will do the trick and I'll be back to normal tomorrow.

How to relax (or not)

Perhaps reading about how smallpox hasn't really been eradicated after all is not the best way to relax. However, the fun part of reading "Demon in the Freezer" is realizing that now I know some of the techniques used in those high-biosecurity labs.

It's been a hard week, what with getting exams back and having papers to turn in. I reviewed my e-mails to non-vet people one day, as well, and found out my writing has deteriorated badly since the beginning of the semester. As the months go by, everything unrelated to infectious disease becomes incoherent and disjointed, and I start talking about salmonella and flaviviridae with increasing fervor.

I talked to the supervisor at work about fixing the on-call schedule so we don't get called in for twenty-four hour stretches. The alternative was probably going to be me giving two month notice and resigning. In some ways, that was an attractive option. I find being on-call to be a loathsome experience. The pager is like a black box of portable stress. If it doesn't go off, I'm worried I might have missed it, so I have to keep checking for the little blinking light. There's always the one long moment where you look at it and wait for it to blink.

If it does go off, that's the next four hours (at minimum).
Some of the people who no longer do this job assure me that, well yes, there are crazy times when you get called in the entire night every time you're on call. But then there are stretches where nothing happens at all! They say this as if it makes everything okay. "There might be times you don't get called in, isn't that awesome?!" Although to be honest, getting called in is not really the problem. Surgeries are exciting, and you learn a little more every time you help with one. No, the problem is cleaning up after the surgery, because then there is no more excitement and it usually takes about as long as the surgery itself. I like to think that it is a less important part of education at this stage; at any rate, I would rather be studying bacteria.

TGIT

I am enjoying the absence of people. My parents headed off to Vegas the night I got called in for five hours. I gripe SOOO much when I get called in, my poor boyfriend doesn't know if he's supposed to tell me when the clinic has left a message with him (I was on my way home and missed the call). And then I spend the first hour going "hatehatehate", the second hour "I'm missing bellydance, aargh!" and then the rest of the evening is fine because I've missed bellydance and how much worse could it possibly get? Well, there weren't any emergency back surgeries that came in, so it didn't get any worse, but I was fully expecting one might roll in any moment. As opposed to weekend before last, where I got to spend ten hours of quality time with the surgeon and anesthesiologist. And an additional five hours of quality time with the cartloads and cartloads of bloody instruments that all needed to be cleaned. I got home at five a.m.

But now I'm not on call for a couple of weeks, which lightens my heart. As for today, no school! As I mentioned, the parental units are off seeking sunshine, and my boyfriend went home with his family, which leaves me with the farm full of dogs and cats (who I can hug because my cat-allergic boyfriend is not around). The bedrooms at the farm were cold, so last night I slept on the couch, which Nanner acting as a very localized heat blanket. Nanner has really mastered the art of staying inside as soon as it gets cold. She finds the person least likely to kick her out and cuddles up quietly, and if they show signs of impatience she starts purring. Since I was the only one home, it was an easy sell.

School switched into high gear the last month, or maybe I did. I think I have passed the most recent round of exams with grades more toward the middle of the pack, which pleases me greatly. A's are awesome, but I am perfectly happy with B's. Even a high C does not offend my sensibilities. (Really hoping the bacteriology exam turned out at least that well). About a month ago I had one weekend with nothing else scheduled, but to study...it was bliss. Since then it has been more of a marathon, with me swearing on a daily basis to never volunteer again, since there's always something else that comes up too. So I'm not too distressed at having nothing going this weekend, although I have a long list of errands I would like to run. Alas, I do not want to go anywhere near the stores tomorrow, but I'm pretty sure it's not a good idea to buy glasses online.

And now I have to go take care of all the animals I promised to take care of today.

Called In

I got done at the clinic around midnight. The clean-up was easier once I found the second autoclave was full of freshly sterilized instruments, meaning I didn't have to run a load myself. On the other hand, the drill defeated me. I wiped all the blood off it, but the mysterious combination of pulling and twisting necessary to disassemble it eluded me.

Around eight o'clock a newly spayed dog had dehisced, and I had gotten a call, "Can you come in?" Seeing as I had been still standing in the surgery ward, I guess technically the answer was "no". Anyway, it was a 4th year's surgery dog from earlier in the day. The resident was delighted to get to do a surgery. It wasn't a huge undertaking, though. She was worried, in fact, that maybe she'd mistakenly called for surgery on a dog that was fine. But to her relief (if not the 4th year's), the student had sutured a layer of fat instead of the linea alba. So yay, there was something to fix!

I don't usually meet the dogs before they're anesthetized. This one was a very thin Rottweiler, from the rescue group. She seemed very sweet--granted, she had just woken up a few hours ago and was sedated again already.

So that was last night! I tormented the other student techs by telling them about it today. No one really likes to hear that someone got called in--it implies there might be a trend!
However, aside from huge amount of cleaning I ended up doing, it was a pretty decent experience.

Not that I want to repeat it every time I'm on call.

Currently things are dull, after a flustered morning. I discovered around 9 am that I was supposed to work at 10 am, and after one false start (I had to turn around and drive home to get my penicillin, since strep is a bad thing and we don't want to encourage it to set up shop on my heart valves) I finally made it in around 10:30. But it turns out we only have one surgery in the OR today anyway. *frustration, tears, whimpering*. If anything turns up, the day will return to frantic haste status.

The thing with strep throat...so, I found out about two weeks after the appointment that I had trace amounts of strep virus. The doctor told me, over the phone, that I should go ahead with the antibiotics, even though I seem to finally be recovered. I hate taking antibiotics, and if I was fully recovered why did I need them? Just take them, he said.

Second-opinion time! I asked my dad (a vet). He said strep likes to catch a ride down to heart valves and after a period of lying low, causes endocarditis. In other words, I'm now dutifully taking penicillin. The moral: explaining the medicine leads to greater patient compliance!

(Further internet research turns up factoids about streptococcus pyogenes, or 'group A': it's pretty contagious, it can lead to sinus and tonsil infections, and more ominously rheumatic fever. Rheumatic fever is the complication that can cause the damage to the heart, since it involves nodules being deposited in all sorts of places, and they can cause scarring wherever they end up. Thanks, mayo clinic website!)

School rumbling on the horizon

So.

Second year!

Oh boy.

Last year around this time I was contemplating the mysteries awaiting me as a first year vet student, the challenges, the joys, the large amount of cleaning my apartment required. This time, much more sanguine about the apartment. I didn't know how exactly vet school worked, going in, but as time passed I found that, as harrowing as it was, I loved it. I have trouble with studying enough, of making it through long lectures and labs with my attention span intact, but it's the sort of challenge that is exhilirating when I succeed (mainly because if I do a good job at it, my brain goes into its happy place and I find myself with a lot of really weird cartoons illustrating my notes, and only a vague sense of time having gone by).

If I were going into first year again, there are some things I would try to do better. I would be far more obsessive about anatomy (though goodness knows I was pretty obsessive the first time around, it just didn't feel like it). I would try to sketch everything, since I found out a little too late that I learn things by drawing pictures of them. Besides, all those missed opportunities to publish a complete anatomy of the cow. I would make flash cards for neuro after every lecture. I would actually USE said flash cards. I might still slack in nutrition, but I would try to more wisely slack in pharmacology. More flash cards (again) and fewer charts. Charts were lovely for histo, lousy for pharm. I would still take that one afternoon off early from lab to go to the zoo. I would think long and hard before taking on quite so many bloody electives second semester.

Of course, most of the things I learned that I should do don't easily translate to second year (at least I don't think so). No gross anatomy, so sketching animal parts is probably out.

We only have one lab that runs all afternoon, though there's always opportunities to stay to the end or to skip out (mentally if no other way presents itself). I learned you should always stay to the end (although a judicious walk to the bathroom that just happens to involve collapsing on a couch for a thirty second time-out is sometimes necessary).

I have a shelf full of index cards awaiting my loving attention--that, at least, I'm sure will be a common theme.

Things I'm worried about not doing so well with: being utterly fascinated with everything. Getting to class on time (usually with three seconds to spare).

Managing to exercise every day. I did so well all year, and then summer came...

And things I want to improve: food management. I'd like to avoid some of the more dangerous of the free lunches (pizza hut's idea of pasta is a macabre joke).

Studying! Always there to improve!

And remembering people's names and actually studying with them. Heh. Found out the hard way that there are some things you can't learn by yourself (thy name is neuro...).

Finally, I'd just like to survive this year of being a surgery tech part time. I think it was a won-der-ful lear-ning ex-per-ience over summer. I think it's decidedly not my career of choice, and I say this now that I have gained a rudimentary level of competence. I'd like to get to a commendable level of competence, this year, but I'm afraid I'll have to muster the enthusiasm on a case by case, day by day basis.

Breeding cows and washing drills

The two days a week of "actual work" seems to be working. Now that I'm more or less trained in at the OR, it's less frightening and painful. I haven't done a stupid thing there for a whole week! (as of tomorrow) By the by, don't put drills and their fancy attachments into the ultrasound (it's a soap bath in addition to the ultrasound bit).

I still have some definite problems with an eight-hour work day. Oh, for a two hour siesta.

The other five days of the week are much more fun. Not only do I get the siesta, I get to play with cows and garden. I've become very nostalgic for the summers I spent training show cows, since there's nothing like dragging a cow around on a lead rope for a couple of hours to make you feel like you've accomplished something in the day. I can't do that now, of course, since the heifers are crazy wild, and I don't have anywhere to show them anyway. But breeding cows is a nice substitute. I get to feel smart that I can identify a cervix via rectal palpation. I only get two weeks to practice though--in July, my job is being outsourced to the bull.

The other good part of breeding cows is that I get to spend so much time just watching them. That's an aspect of vet medicine I feel I'm going to have a lot of trouble with. "What do you mean, work with other people's animals? Without two hours of observation?!"

Plus, I'm spoiled by having very professional cows. We don't keep any cows that kick or shake their heads at us, and you can usually talk them into going through a specific gate. Besides, they're Angus. I'm afraid this has left me with a strong opinion of what a "proper cow" looks like, which makes the far-more prevalent Holstein look like a sad, warped version of a bovine.

Training does not have to equal train wreck

I am relieved to discover that after three days of full time work, I appear to have some idea of what I'm doing as a tech. Of course, now I've come down with a horrendously sore throat and still have the prospect of a two more eleven-hour work days this week, but hey, at least I have today off. The supervisor was terribly worried that I traded off an on-call shift three weeks from now, because how on earth will I get experience working in the OR? Aside from, y'know, the EXTRA DAY THIS WEEK that was the other part of the trade.

I was also glad to hear from my dad that, no, his clinic doesn't tell techs to "just dive in," and leave the training at that. They hire all certified techs, first of all, not random first year vet students, and they still have a very well defined training program the techs go through. 

One of my observations from work yesterday is that, as wonderfully effective as learning through (devastatingly bad) experience is, it means no one is sure what everyone else knows. We're just suppose to train ourselves so well we know everything. So we end up with things like an entire batch of medical equipment to resterilize, because one of the student techs didn't realize that the pointy ends were going to poke through the wrappers. It wasn't me! It was one of the "dive right in" proponents, ironically enough. 

Enough blathering for today. It's time for another dose of vitamin C and hot tea.

Rant

Summer...a time of relaxation and recuperation from a tough semester. Or not. I had been really really hoping I wouldn't get called in on Sunday, since I didn't realize until Friday afternoon that I was going to be on call, and I hadn't spent time learning to be a surgery tech since before exams. 

And let's face it, I never really got a good chunk of training any time over the semester. Pretty much ever since the second week after being hired I've known this was not what I wanted to do, though I'll blame it on the stunning lack of any training program for student surgery techs. How much training do real surgery techs get? I'm sure it's more than "whenever you have a spare moment to be in the clinic." Not to mention "Don't worry, you'll learn it on the job this summer."

Ideally I should have been smart enough to not sign up so quickly and willingly, or at least, in that second week, to have returned to the person who hired me and said, "Look, I didn't fully understand what the job entailed, I have significantly more time committed to labs for class than your other student workers, is there a way to work this out?"

Actually, truly ideally they would give you a chance to shadow someone for a full shift before even hiring, so that they get a student who wants to work there, rather than someone who has been told "It's such a terrific opportunity, it's really easy, all you have to do is [simple, minor time commitment]." And then have a trainee manual, which has all of the relevant information for the job (like, on which one of the multitude of calendars you are supposed to put your on-call contact info, and where to find keys for the supply room).  

What sparked this off was me getting called in on Sunday and being an incompetent idiot. I don't like being an incompetent idiot, even when another student charitably comes in and takes over. I didn't know even how to open the supply room to get the surgery supplies, so it was assumed I don't know how to set up for surgery. Throughout the surgery I found other ways to screw up. At least I knew how to clean the room afterward. Then we were called in again, an hour later, adding up to 8 hours of frustrated efforts to be competent.

Unfortunately I'm the sort of person who generally ascribes all problems to her own failings, so most of the semester I was thinking, "I just need to work harder, it's my fault I'm having so much trouble." Add in lack of people skills and confidence to use them (I've been working on that), which makes asking for help that much more difficult. So it was my own fault I didn't speak up to the (extremely unsympathetic) student in charge of scheduling, my own fault I didn't learn everything I needed to know on the job, and my own fault I was having so much trouble with classes that I was spending a lot of afternoons trying to keep up with school rather than learning how to do a job where I was told "Don't worry, you'll learn it this summer." Well, it turns out I am  learning it this summer, the hard way, inconveniencing other people and really stressing out myself.

As a communications major, it astonishes me that the OR of a well-respected clinic has such a dearth of training policy that an inept student remains inept for so long, and then is expected to know everything they need to when the learning of it is left entirely to chance and the assumed tenacity of the student. There is no manual to refer to, there is no effort made to introduce the student to the job. I did not know that veterinary surgery endorsed the discovery learning method.

Really ought-tos

I really ought to study more.
I really ought to get more sleep.
I really ought to get fewer groceries (but...chocolate!)
I really ought to not sign up for an overloaded semester...oh, wait, already did.

It's hard to be enthusiastic in anything other than short bursts right now. I like when school is neat, clean, limited to lecture halls and labs with pristine microscopes. But this semester I'm dissecting cows and horses, and must venture out every week to work with live ones in a cold barn. I'm dreading the commute more than anything. And some part of my brain decided it would be good experience for me to sign up for shifts in the large animal barn and a job in the small animal surgery. Which, since they are considerate of students having lecture during the day, has all the shifts going from 6:30 pm to 8 am the next morning. Granted, it's on call, but then that just means getting called in at 4 am, the morning of a school day. And buses don't run at that time. Was I insane? *nodding head vigorously*

But all this griping is done on the assumption that I'm temporarily ruffled and, once I start in on all of the above, its sheer fascinatingness will win me over.

For now, though, hand me the chocolate.