Sunday, June 5, 2016

Week 3 RREH Ambulatory

           I can't believe it's been 3 weeks already!!! I'm learning so much so quickly! There's something new to pick up every day. This week, I think my big take away was that the clients can make bad days. We had several days of dealing with rough clients that made for a rough week even though we were having success with the patients.
           Sunday was a crazy day. The intern "graduation" party was being held at the anesthesiologist's house in the early evening, so we were all trying to make it there on time. I started out with Dr. Friend. Several of the barn managers were trying to push their times back, so they could sleep in. We also learned about a few mares that had come in from out of state that would need afternoon flushes. We got a bunch of lavages and baby treatments done by 10 am. I learned how to remove the Caslick's stitches and do infusions using a speculum instead of inserting the pipette into the cervix by hand. At 10, I was handed off to Jordan. We did some more lavages and removed a retained placenta. It was very interesting to watch how she carefully pealed the placenta from the uterus. After she got it out, we inspected it to make sure it was all there and ran some fluids through to rinse her out. Then we were called on emergency to replace a catheter in a mare that had pulled it out overnight. I got home right as the party was supposed to be starting. A quick shower and change made me an hour late. Dr. Friend pulled in right behind me. The first hour or two was really awkward for me because everyone was in their little groups catching up. I didn't want to cling to Dr. Friend, so I stood and sat by myself until Jordan got there. She had laid down for a 10 minute nap that turned into a 25 minute nap. She pulled me over to a table with a bunch of interns and Dr. Friend introduced me. After a bit, I went and played cornhole with Dr. Friend and 2 of the interns. After that, everyone was a bit more open to talking to a new person and I was a bit more comfortable with talking to them. It ended up being a lot of fun.
       

       The scenery is so beautiful here. I get mesmerized just about every morning as we drive between the first couple stops and the fog is still lifting. I finally managed to think about taking a picture of one of the beautiful views.




      Monday was Memorial Day, but that just meant more traffic for us. Jordan and I relocated a snapping turtle that was walking along the road to start off the morning in a bright light. We had an interesting day treating 2 lame horses out in their respective fields. The first had a rather unique pasture mate. She is a mammoth donkey. The owners informed me that they are a critical species.

This particular farm has a variety of fun creatures running around. In the adjacent pasture was this little stud. I had fun seeing all the different equids, but we had to run to get to our second lameness.

Our second lameness was caused by a large abscess under the hoof wall up by the coronary band. Jordan was able to pop it with minimal pressure. Despite the stubbornness of the horse, we got the foot wrapped in a soak bag and told the owner to cut the bag in an hour to drain the soak and then take the bag off. This was the first difficult client of the week. The air was much less tense as we left than it was when we had arrived.

  There was a beautiful sunrise on Tuesday. I was able to enjoy it on my way to meet Dr. Friend and his tech, Kimmy, after his resistance class. We were getting through our routine stops pretty quickly in the morning, so Dr. Friend moved his dentist appointment up to an earlier time slot. I had made arrangements to go back out to one of the farms to watch for a potential foaling in the evening. When we got to that farm, the foal had just been born. I talked with the manager and changed the plans to be at the other farm for a late night/ early morning foaling. I got to do the placenta inspection and help run plasma to the foal. I learned that it is common practice around here to run plasma to newborn Arabians before they start showing signs of needing it due to the higher risk of issues. We did a joint injection and several radiographs. It was fun to see how that process went. Kimmy and I dropped Woodrow off at his appointment and went back to stock the truck between stops. He got a nice nap in the grass under a tree while waiting for us to return. We were called by a panicked owner of the abscessed horse I saw with Jordan yesterday. Dr. Friend had to dig quite a trench in the foot to get the hole from a previous abscess from the underside of the foot to connect and drain some more pus. He put on another soak. I got to hang around with the horse to make sure the soak stayed on and the he came out of his sedation without any problems while Dr. Friend went to take care of the last 2 stops for the day. When he got back, we took off the soak boot and showed the owner how to wrap the foot to keep debris out of the trench. They informed me that the second foal had been born while I was standing with this horse. It was quite the day.

      Wednesday was another crazy day that started out normal. We did several routine ultrasounds, palpations, and lavages. The tow of our early stops were very disorganized and took longer than necessary to get the horses in place. They also both had a lot on the books for the day. I got to watch Dr. Friend band a hernia. That was interesting, but we didn't talk much about it since we were so pressed for time. This is one of the times I feel like I should know more than I do and feel silly asking questions. Jordan took care of one of our stops, so we were closer to being on track again. We did a bunch of recheck radiographs at a fancy barn with a bunch of fancy yearlings. I didn't enjoy that much because it was very fast paced and I wasn't able to do anything because the horses were worth too much. It really does make a difference to be getting your hands dirty. Even holding a tail out of the way feels better to me than just standing there trying not to be in the way. At the next stop, I got to shoot some hoof images. We did a pre-sale survey on a yearling and a pre-purchase exam on an older horse. During the pre-sale survey, Dr. Friend was quizzing me about the images. It was good to remember and have my memory jogged.

       I took Thursday off. I caught up on sleep, took a nice long shower, and filled up my fuel tank. A random guy offered to buy my truck. When I got back, I made myself some banana french toast for dinner and a couple future meals.

     Friday, I started with Dr. Friend. We had a happy start by finding several pregnancies. I'll have to try to get some pictures of ultrasounds to show the differences as the little things grow! A cast horse threw us off track a little bit. The horse seemed a little neurologic and had some swelling in the hock, so we said we would come back later and do some imaging. We did a lot of flushes. Dr. Friend taught me how to take a culture/cytology sample of the uterus. I got to take out some more Caslick's stitches, do some more blood draws and injections. I went with Jordan to see a stallion collection. We had to meet up with Dr. Friend again to get the portable x-ray machine after he imaged the horse from the morning. The leg looked fine, but there was some narrowing in the cervical spine that suggested neurological issues. We submitted the images to the radiologists for a better look. Then it was off to the circus. Kimmy came with us to help do pre-sale surveys on a couple of horses that might as well have been feral. We were only able to catch and get one calm enough to do the survey. The other hadn't gotten pre-medicated by the owner, so she was too worked up for the sedation to work. The owner seemed rather peeved that we had to reschedule, but it was not a safe situation. We still had several stops to make and didn't have time to be wrangling his yearling. We did a couple checks and breedings before doing a field castration. It was a lot of fun to put on the sterile gloves and get in there. I quickly learned that I don't have enough forearm muscle for using emasculators yet. It took a lot of convincing to get him back on his feet.

        Saturday seemed like two days. We had another rough, disorganized morning. The horse that had been cast yesterday was down again. It took several guys pulling on a rope under her bum to get her up. The next stop had a foal that had been born in the field. A mare got her foot caught in one of the panels of her holding pen. And one of their goats took off with the billing book. All that craziness set us back and pushed the limits of Dr. Friend's patience. Towards the end of the morning, I got to do a couple lavages. I stopped at the clinic on the way back to the house. I sat on the bed around 1:45 and woke up at 5. I was able to go over to the neighbor's and do my laundry before eating some leftover banana french toast.

There is so much to learn! I love being out in the truck despite the early mornings, late nights, and return to caffeine. The days off are nice but the next morning is no fun. Sleeping in throws off the rhythm of little sleep. Naps don't seem to be as bad, as long as I don't stay in bed too late. It's crazy to think I'm already a quarter of the way done!


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