Back Again

So what's happened recently? Not much really apart from work and play. I've been on quite a few rotations since my last entry and mostly loved them. There wasn't a whole lot of work on imaging, but oncology was fairly busy.

A few weeks ago I was a bit ill and had a brief hospital stay. It wasn't the most fun experience (I'm pretty sure our patients get treated better) that ended up with me discharging myself after waiting for an ultrasound scan for several hours.

Feeling better now though and back on to night duty. I'm still feeling tired a lot of the time, but the current batch of students are very useful and I'm getting some rest.

Time Off

Internship is all fun and lots is being learned but sometimes time away is required. This weekend I took an evening off to escape to the city, see some of the festival and meet up with a few old friends who were visiting. It was a great night out!

I find it far too easy to stay late here and follow cases that I've become involved with even if I should have been away hours earlier. Work-life balance is important though, and so more time will be spent escaping.

Night Shift

Well that was fun! I survived my week on the night shift. It was fairly bad with at least 3 cases there each night, but everything survived, even the 2 animals that tried to die at once.

There were a variety of emergency cases such as the feather plucking cockatiel at 3am and the sick Labrador (has he eaten something? Are you sure?), although most of the people that called me weren't actually our clients. It was very strange that I had to send at least 4 people back to their own vets, including one complex cases that was in Northumberland who we'd never seen! They weren't even in the area! Weird.

Still catching up on sleep. I went to a friend's wedding this weekend. It was great, but I was exhausted.

First Few Weeks

It's been a while since I've been able to write anything due to lack of computer access and no internet connection, but so far today the wireless is working. Woo!

The internship is going well. I have been switching from service to service as required including exotics and feline medicine. So far I'm loving being back, it's great to see everyone again. Some people even seem to remember my name which is rather worrying.

Night work starts tomorrow which I am not looking forward to, although at least there will be various people around for backup should it be required. After that I'm moving from one flat to another in the intern building, then heading off to a wedding.

Back to journal review for tomorrow.

Interning changes

There's been a few changes to the intern program whilst I've been in Wales! First of all I'm starting a 13 month course instead of the usual 12 to cover various holidays and locum on the services. It will hopefully give me extra time to figure out what I'm doing and get me settled in too. And any more time in Wales and I'd go insane.

Currently there are 3 interns who share the load between them. This means 1 week in 3 is nights, and they work every 3rd weekend. I think someone may have mentioned the working time directive as on a busy weekend the on call vet may only have 8 hours sleep total! So now there are 4 new interns.

This means we will only be working 1 in 4 weeks of nights (only 12 weeks? Doesn't sounds like a lot!) but to cover the weekend efficiently we are going to be working 1 in 2 weekends. Basically if anyone is looking for me, it's a good bet that I'll be at work.

And finally a big YAY! to all the final years who passed their exams, including my Lab Partner from first year. Well done!

New Job

Well it's confirmed, I have a job for next year - I'm heading to be an intern at University! Very strange way to get a job, they heard I was looking and offered me a position. I didn't even apply for it! Not that I'm complaining in the slightest.

So next year I'll be back in the vet school learning loads and hopefully not hating all of the out-of-hours work too much. There is an element of teaching and supervision the final years involved but that shouldn't be too much of a problem.

Before then I'll be heading between locum work and staying Wales where hopefully there will be time (and the right weather) to climb a bit. I have a load of gear that needs testing!

Quick Update

I'm back off to Wales tomorrow for a while, but first I have to give the talk to the 4th years. I decided to be honest in the end about the shortcomings of the job I've had, but also about myself. Should be fun!

I also got a phone call yesterday about a potential job but I'm still waiting to hear back for certain. It's only for a year, but I'll hopefully learn a lot. More details soon!

Goodbyes

Over the past week or so I seem to have been seeing the same clients that have stuck in my memory (for better or for worse) over the past six months.

First was the lady with a new puppy. I sadly had to put her oldest dog to sleep on boxing day, so I'm so happy to see her with a new dog as well as the regular pup too. Then came my first caesar dog along with the pup that the owners were keeping, followed closely by a dog who I saw roughly every other day for a few weeks to re-dress a wound.

A few other memorable faces popped up too, such as the lovely lady who thanked me for putting her old dog to sleep with a lovely card and the twitching dogs I'd seen a week or so before.

I will miss the people here. Mostly.

In a more fun note I'm back off to uni for a bit in 3 weeks. I am going back to lecture the 4th years on how terrible the life in practice is. Not too sure whether I should be nice or honest about my experience so far. Probably honest.

Long Weekend

This was my last weekend on call. Yay!

It was also horrible. Boo!

Most of my time at work is spent with small animals. In the past month, not counting the weekend, I can count the numbers of times I've seen a cow or horse on the fingers of one hand. This makes visiting things out of hours very difficult.

Sometimes I need backup but I try not to call someone unless I really really need help. Sadly as a new grad this is more often than I'd like. Such as a cow caesar. Sadly my bosses don't think the same as I do and aren't as helpful as I'd like.

Grumpy doesn't really describe my reaction to the lack of backup and the attitude given by a member of the group. It all makes me glad I'm leaving.

Label Reading Mk 2

The last incident of a client not reading the label on the various drugs we hand out was quite daft, and quite funny. Sadly this one isn't as much fun.

We routinely hand out flea and worming "spot-on" products to clients. These days it seems like most of the things we give out go on the back of the neck, and we just assume everyone knows how to use them. Not so.

A combined flea and worm product is not meant to be put in the dogs food. It causes seizures, twitching, vomiting and generally unhappy dogs. The drug company was very helpful and gave great advise for which I can only thank them. Three dogs, all with the same signs. It was a fun day!

One dog has gone home. The second and third dogs are staying in overnight for monitoring and we hope they will sort themselves out. Someone is in the doghouse at home.

Please Read The Label

Conversation with a client this week:

"My dog's arthritis isn't doing very well on this liquid stuff you gave me. Her ears are so much better, if only she was happy to go for walks again"

Discussion ensues about the effects of non-steroidal drugs, how all dogs react differently and how we can try tablets instead of liquid, or we could just up the dose to a little higher.

"The dosing syringe? That's for the stuff I've been putting in her ears..."

Silence.

*slight giggle*

"Urrrrm...that's the one that's meant to go on the food. You mean she's been having ear drops in her food and metacam in her ears?"

"Oh yes, wasn't I supposed to do that?"

You have to wonder sometimes. The big label saying apply to both ears on the ear cleaner may have been a bit of a give-away. And the picture of the ear. And the instructions.

The ears got better though!

Mystery Dogs

We've had a few weird cases in recently, but this one wins the prize.

This young dog had been running in the woods, left her owners behind, and then gave a huge yelp. The owners found her standing against a tree hold up a back leg. Seems fairly straight forward so far!

Quick exam - one leg shorter than the other. Breathing a bit fast, how's the colour? Ooooh, bit pale. Very sore though, could be pain and shock. First things first, lets break out the painkillers. Another poke and a prod to check for other injuries showed up a bit of crackly skin over the ribs. Air under there is a bad plan!

A few x-rays later we found a broken pelvis, 4 broken ribs and a collapsed lung. And no clues as to how this happened.

Calving Mk 2

Another day, another calving. Different farm this time, and at least this farmer had an idea of what was going on and knew to call the vet before it was too late. In this case he'd had a feel and there were two hindlimbs coming and the feet were quite big.

Thankfully I wasn't sent alone this time and we examined the cow and tried to assess if the calve could come normally. After a bit of pulling the decision was made - caesar.

It's been a good few years since I've seen one so I was happy to have the help! We had a nice debate on the merits of various local anaesthesia techniques - distal paravertebral, line block, inverted-L etc - then got on with it.

She was fairly well behaved considering what we were doing! The only difficult part was lifting the big 60kg calf in to the big wide world. They aren't the easiest things to lift at the best of times, and even worse when wet and slippery. The student put his back in to it, lifting and pulling and was rewarded by falling over in the shed with the calf on top. Thankfully he saw the funny side.

End results was one live calf, one live cow, one happy farmer, and a couple of vets with a few more bruises than we started. I've never yet managed to suture a cow without stabbing myself with the needle.

Calving

Calving number 1 appeared the other day. I was the only "large animal" vet around the place who was marginally free. Never mind that I'd booked an operation in just for me to do...but that's a different story.

I arrive to find a cow still in the shed with quite a few others, not at all separated. Suspicions that this was going to go badly started then. The suspicions were confirmed when the farmer asked why we needed to move her, and why we couldn't just get on with it in the shed.

Calving is a messy, painful and generally suboptimal time for all involved. This time is aided by proper restraint for the cow. Attempting to calve whilst the cow is allowed to run free is just asking for a broken arm.

The epidural went in fine. Tail floppy. Everything relaxed and easier to feel. There are feet. Tick! Ideal! And then a head appears. Tick! This shouldn't be too hard thinks me...bad mistake. Thought number 3 was "these feet feel a little small". Possibly twins. Sadly already deceased. Not too bad though, done this before. I can't trace the legs all the way back to the shoulder, my arms are too short. But there's a head right there, this all has to be the same calf right?

Wrong.

Somehow the calves were coming both at the same time. Calf 1 on top had head forward but legs all the way back. Calf 2 had legs forward, head all the way back. This made for a poor mix.

Thankfully help was at hand. I was rescued by another vet who was "just passing" and happened to see my car. She has longer arms and, more importantly, over 10 years experience doing this kind of thing. And she struggled too.

It was an OK outcome - the cow was still alive. Sadly the calves were dead. We were covered in bruises, sweat and blood, but that's just part of the job. Back to the practice for tea!

Leaving

Well the time has come to escape my job. There are a variety of reasons, most of them really boring and grown-up. Basically I'm not getting the exposure to the farm animal work that I'd like and thus I'm not confident in it at all. Most of the time this isn't a problem, however during on call periods it's the source of major stress that I just don't need.

Anyone need a vet?

Dear Driver

I'm sorry I wasn't going fast enough down the dark country road at night to suit your needs.

I'm sorry I didn't really know where I was going.

I'm sorry I delayed your journey by about 30 seconds.

Yes, I understood you were upset by the flashing of light and beeping of the horn, there was no need to shout too.

I was on my way to my first equine emergency call you see, and I had other things on my mind such as - What will the heart rate be? Will I need to rectal this horse? Do I have all the emergency numbers? What's the dose rate for all these drugs? Where am I going? What's around this corner? What if I need something I don't have in my car?

Vets driving to emergencies are a dangerous breed, especially new graduates, especially those new to the area who don't know the roads.

I figure getting sworn at, or arriving 5 minutes later than planned is better than a dead vet. So if you're stuck behind me, I'm sorry.

Weekend On Call

Weekends on call have to be the toughest part of the job, especially in a mixed practice. So far I've had about 3 hours sleep since I started work on Friday morning.

Last night was hard work - just me and various sick animals. I'd have killed for a nurse to be there to give me hand! Dogs having seizures filled the majority of my evening after a busy day consulting and the night was spent monitoring them at work. In the end I gave up coming home between visits and just bedded down at work.

This morning I planned to come home for a shower and breakfast...which didn't happen until 1. Only 21 more hours to go.

Quick Change

I love this job because of the variety we see on a daily basis.

Today I was visiting a farm for some sick cattle, we had the usual chat about housing, the weather, the job and everything else whilst trying to examine some mad yearling beef cattle. Just when I thought we were done for the day, liberally coated in various bodily fluids, the farmer pops the question that always comes up:

"While you're here, can you just look at....."

This is why all calls take twice as long as they should. Examining cow to cat in the matter of minutes. Love it.

This isn't the cow I was examining. But hey, close enough.

Sometimes I forget...

...that I'm actually qualified and a real person now. People keep asking for opinions on clinical matters, but even more worrying I seem to have the answers at least some of the time.

The past 2 weeks have been manic with busy consultations and various emergencies. In the space of 48 hours we had 5 RTAs! One day I started to X-ray a cat at 9am calculating sedation drugs and then met the first of many RTA dogs. On the plus side most of them survived with only one casualty. It was so manic we even had students keeping an eye on some of the inpatients.

Farm work isn't going as well though. There isn't a lot of it going around and the usual farm vets take most of it. This leaves me with the emergency work which would be great if only I had the experience to deal with it. Over the next few weeks I'm hoping to be more proactive and grab some more farm work to get me up to speed.

Equine work, as ever, is evil.

Happy New Year!

It's New Year! Woo! I've been coughing up a lung for the past couple of days, and I'm on call. Not a great start to the year, but these things happen. Not too many patients in and hopefully people will realise it's Sunday and we are still closed. Tomorrow morning may be a different matter.

I may try to blog a night on call at some point, but it depends on if I can be bothered to turn the computer on at 3am. Unlikely.