SQUEE!

I can't believe I'm going to say this...but puppies aren't the cutest things in the world.

They are second to kids.  And by kids I mean little baby goats.  And by little baby goats I mean the ones that I cuddled for a solid hour during lunch today.

I submit these as undeniable proof of their cuteness.  Exhibit A.  A standing for "adorable".

Valentine's Day studying

Geez, I need to be better at posting in this.  It's not that my life is so boring there's nothing to write about, it's just that it's so BUSY I don't have the time to write about it!

Tomorrow is our big exam day with both our first anatomy and virology exams of the semester.  Apparently it's school policy to not have two exams scheduled for a class on a single day...not quite sure how this one managed to happen but hopefully it won't be too much to our detriment.  Anatomy covers four species and their necks, backs, thorax cavities, and abdominal cavities.  Sooooo, kind of a lot.  But at least it's a known "unknown" since we've been through this once before with small animal anatomy last semester.  While the comparative stuff can bog you down with details (the last centrifugal coil of the goat spiral colon?  The medial and lateral cecal arteries in the horse only?), there doesn't seem to be as much teeny minutiae as last time (muscle attachments, innervations, etc.).  Plus, now that we kind of know the language and how to study best for this, it's not as challenging the second time through (hoping I'm still singing that tune tomorrow afternoon!). 

Virology has me a little more worried.  I think know everything I'm going to know for the test but I have this feeling that the questions are going to be asked in a way I won't recognize.  The first exam from a class or professor is always a little frightening, especially now that the school has made it a policy to not allow old exam sharing between classes. *sigh*  That'd be awfully nice to have in place.

Extracurricular stuff has been interesting lately, too.  I entered a baking competition run by the theriogenology (animal reproduction) club and actually won!  It was a brownie Oreo cheesecake recipe that turned out to be pretty deadly.  Definitely going to be making that again sometime in the future!  SCAVMA (kind of the student-wide government for the school and the student part of the AVMA) applications are now open for board elections and someone nominated me for secretary, so I'll be running for that.  I think I'm up against a second-year, so not really sure if I'll be getting it.  Doesn't hurt to try!

I also interviewed for the school representative for Bayer pharmaceuticals, which is a two-year position.  The interview was...weird and it made me kind of unhappy.  I showed up ten minutes early and the room was closed with an older gentleman and a student talking - figured it was either an interview or they were discussing applicants.  In either case, I decided I'd wait outside until they were done and it was time for my interview slot.  A good fifteen or twenty minutes went by before they realized I was outside and let me in; not a good start and they probably thought I was late and not just waiting for an invitation to come in.  The interview itself only consisted of two questions (What are the duties of this position?  Why do you want the job?) and then an invitation to ask them questions.  To me, it was not a fair evaluation of me as an applicant, especially considering the application only asked for our GPA and identifying information.  I brought resumes along (which they also didn't ask for) and they took them, but I had a feeling that they'd already made up their minds about me before I even entered the room.  In a bad way.  Oh well.  It was a pretty sucky feeling considering I actually spent some time researching the products, preparing some answers, and finding out more about the company.  They haven't announced the pick yet, but I guarantee it wasn't me. :(

And Valentine's Day!  I told the boy that this past weekend was NOT a good weekend to visit (see exam schedule above.  Gross), so we're spending time together this coming weekend.  And I won't have a ton to study, so it should actually be quality time!  He surprised me with a flower delivery which was not red roses.  Those are some of my least favorite flowers and the white, peach, yellow, and deep pink ones he picked were way, way prettier.  He did good. :) I have a gift for him and will likely be baking something tasty to bring along (I'm leaning toward some giant chocolate chip cookies or red velvet whoopie pies).  I looooove baking!

Early spring?

After that massive snowstorm hit just about the entire United States while I sat here in Raleigh enjoying 65 degree January days, I wonder if winter is just about over for us down in the south.  It doesn't get much below freezing, even at night, and the days reach about 50 degrees.  It'd be nice to have some warm weather as we start up our outdoor labs again, but I hope spring holds on for a long time because I'm in noooo hurry to see a hot sticky summer!

Our first round of exams is over which means we've finished one immunology, one physiology, and one embryology exam in addition to our first behavior quiz.  They weren't bad at all, but I'm just sad that now our attention has to turn to the big anatomy exam and virology exam, which are BOTH next Wednesday.  Eeek!  Considering how far off these were, I've been kind of pretending that they don't exist and haven't been paying tons of attention to them.  Really going to be a nasty week catching up and getting ready for those. 

The good news?

1) Just had a weekend with the boy to keep me happy.  It was kind of lame since he had a ton of work to do, but even just watching him take a practice GMAT is quality time when you're juggling the joy of long-distance.

2) Heading up to my undergrad alma mater in two weeks with the boy to see a ton of friends and his family!

3) Pet-sitting for a classmate this coming weekend - a bulldog and four cats!  Too cute!

4) There's a baking contest at school next week.  Thinking of entering a recipe for chocolate-chip cookie dough cheesecake.  Mmmmm.

5) Boy and I are hoping to go somewhere fun for spring break.  He's having a heck of a time organizing with the whole frequent flyer miles restrictions, but he tells me it will be fun.  Honestly, I don't care WHERE we are.  It'll be nice to get more than 48 hours at a time with him.

6) I got a pretty high number for my selectives choices, so I'm hoping that I get my first choices - sample collection and small animal dentistry.

7) Necropsy and gross pathology rounds on Saturday morning!!!

8) We're already 1/3 through our classes this semester.  O.o  Why do I feel like I don't know anything yet?!?

On another note, I applied for the Bayer student representative position and have an interview on Thursday.  I have a feeling a good dozen of my classmates also applied, so I'd be shocked if I actually got it.  We'll see!  I think I'll throw an app in for the BIVI representative spot as well to see what happens.

And so it begins.

First exam of the semester was this morning!  It wasn't really an exam - more like a glorified quiz - but it covered some of the basics of immunology.  Not too bad since it was only a few pages of true and false questions and definitions.  Cardiovascular physiology is on Thursday, and that's a big one.  Our physio is divided up by body section/system so each exam only covers that one system in detail.  I think it'll be tough and comprehensive, but at least this stuff makes sense to me (for the most part).  There's also a behavior quiz on Friday, but I don't think that's even on the radar for most of us right now and should be cake.

As much as I would have loved to get some of that nationwide band of snow and ice (it's just not wintry enough down here!), it's a relief that we don't have to worry about making up our missed lectures.  In undergrad, a delay or closing didn't really matter (even though we only got a total of one snow day in four years).  Teachers just sped up a little or omitted the missed material.  After our snow day on the second day of the semester, we had to find time to attend make-up sessions with our lecturers.  It's so much of a hassle when we're already cramped for time that it's not even worth the fun of snow!  All the same...having days of 65 or 70 degrees in January is freaking me out a little.  It's not normal, and it's also not the best way to stay indoors and be productive on weekends!

It's been interesting to see the changes in students since last semester.  There's definitely been more backbiting and high school attitude going around.  I don't know if people are more stressed, getting sick of each other, or just realizing that this constant go-go-go is how our lives are going to be for the next 3.5 years.  Overall, the class still gets along great - we're cohesive, support each other, and are very enthusiastic.  There's just been more complaining about each other or little tiffs between students.  Hopefully it's just the stress of the first round of exams... 

The only issue I have with the class as a whole are the grade-A stressors.  I used to be one back in high school and early undergrad.  Panicking, crying over tests, weeping over missed points, making myself ill before exams, etc.  Sometime during sophomore year - I think it was because of organic chemistry - I just sort of realized that all I could do was study the best I could and see what the exams threw at me.  You can't know every single detail and major stressing was only setting me back and making school miserable.  That adjustment has really helped me stress less, study better (and less on the whole!), and do better in my classes.  It's an important skill to learn, and I think it comes to students at different times (if at all).  So while I sympathize with the study-holics and know where they're coming from, sometimes I just want to tell them that it will all be better for them if they take a deep breath and relax.  Nothing aggravates a day of school when you arrive perfectly happy with your level of knowledge and grasp of concepts and then have to hear constant cries of, "I'm going to fail!"  I mean, I study a lot, but not every single night for every single hour I'm home.  I've found a way that works for me, and it's cut down on how much I have to spend with the books to get the grades I want and need for further training.  Also, there are a few things I won't sacrifice for school even if it means getting a B rather than an A on an exam - my sleep, my sanity, and my relationship.

However, according to several professors and other classes, we're one of the most relaxed groups to come through the school recently.  Don't know how I would have handled being in a class with MORE of this kind of anxiety!

Oh, Wenckebach.

This will likely not even be amusing to anyone not in the medical fields, but we got to watch it during cardio physiology the other day and couldn't stop laughing.  It's describing a phenomenon called Wenckebach or AV Block Second Degree.  Basically what happens is your atria depolarize normally but sometimes the conduction to the ventricles gets skipped and you lose ventricular depolarization for that cardiac cycle.



Cardio is great - I'm really enjoying it overall, and it makes a whole lot of sense (which is a relief since the exam is next week!).

Anatomy is still messy and gushy as always - we're now in the abdominal cavities of our cadavers and are comparing GI tracts which are very different from each other as well as the dog and cat.  The ruminants (goats and calves) have huge multi-chambered stomachs and a very looooong jejunum and large intestine.  The large intestine even does this awesome coil at one point!  The horse is just weird and has an expanded cecum and long, torturous, winding large intestine which makes you realize why they colic so much (10% of horses annually!).  Also, our goat is pregnant so we're really excited to start the reproductive tract dissections in a few weeks to see the placentation of the uterus.

The class is chugging along as a whole.  The consensus is that immunology isn't the greatest class ever - it's way too condensed and chopped for the density of information.  Some things (like biochemistry or immuno) are actually easier to understand if you have to learn and memorize a ton of details.  It makes everything clearer in the end.  This course is being taught as a very broad overview of a lot of things and it isn't going to have that nice neat moment of clarity at the end.  Oh well.  Exam also is coming up early next week, so this weekend will involve a lot of book-time.

On a non-class related note, I'm trying to eat a little better this semester and stick with salad every night for dinner when possible.  I don't care much for the three or four pounds I've gained since vet school.  I wish I had the willpower to give up the lunch meetings but it's one of my favorite things during the day!

Fun facts!

What I learned in cardiology today:

Ventricular fibrillation = heart spazzing out = death sentence

Atrial fibrillation = heart spazzing out but significantly less = can normally function

Also, ECGs are crazy-awesome in how much they can tell us but are also going to be crazy-tricky to really get a handle on reading.  And if you mess up on reading ectopic ventricular contractions and give lidocaine to fix a non-existent problem, you'll end up severely compromising or killing your patient.  Huh.

Productivity...?

First week down and it's time to get serious!  It was super-difficult to get motivated to study much in the past week - we just started, had a few snow delays, not much coming up exam-wise, boy was here this weekend, etc.  Plenty of excuses and justifications for that.  Now that the first week is over, I think it's high time to get started with the hard-core studying routine.

So far classes are going great - no major duds or anything thus far!

Physiology - LOVING it!  We're doing cardiac physio to start the semester, and I'm actually really liking it so far.  The notes are clear and really interesting, so it's the perfect way to start the day at 8 am.

Anatomy - Now that we're in large animal/comparative anatomy, the labs are definitely a LOT messier!  We're doing dissections on a calf, pony, and goat in each group and are using pig pro-sections for additional comparison.  We are FLYING through material, too.  A lot of it sounds at least familiar or similar to last semester but there are also a lot of changes.  Not quite sure how to think about or approach the exams yet, so we'll see how this one goes.  But the lectures and textbook are very entertaining thanks to the guy teaching!

Virology - Just had one lecture of this so far, and the professors seem really great and enthusiastic.  I don't know too much about viruses yet, so I'm excited to learn more.

Immunology - I had a pretty in-depth course in undergrad, so this seems like cake right now.  I'm actually really thankful I have a background in what we're doing in the course, because they're flying really quickly through the material.  Our labs are going to consist of small group case discussions which will hopefully give some good practical skills to go along with the book learning.

Embryology - Also a new subject to me, but it seems very straight-forward and the teacher is very sweet.  Only have this one once a week, so I doubt it'll be too intensive.

Behavior - Eh.  Seems pretty basic and simple so far (even though it's not really my cup of tea), but we do have to complete an animal training project.  And since I have no animals here to speak of I'll need to attach myself to a friend and their dog to finish it.

Production Medicine - More of the same from last semester.  We get an additional lab with each of the major large/food animal species, and it seems like this semester has a slight focus on nutrition for each species.

And that's it!  It's been great to get back into a routine and see my classmates after a long hiatus.  Winter break was definitely super-long now that I think about it, and I'm ready to start the learning process again.  I've also managed to get a lot of my summer research project squared away - I'll (hopefully) be studying epithelial to mesenchymal cell transition in pulmonary tissue.  That's a change that occurs frequently in fibrosis disease patterns, and there's a new gene of interest that controls a lot of this process that is actually considered a cancer gene.  Should be interesting!

Semester Two - GO!

We started our second semester bright and early on Monday morning...and then proceeded to have an ice day today and a delayed opening already on the books for tomorrow.  The whole doing-nothing thing is great, but at this point I'm just ready to get back to a schedule.  We started our anatomy lab dissections yesterday (large animal this time!), and diving into a goat, horse, and cow is much sloppier than with cats and dogs.  Definitely wearing my rubber boots to lab this semester!  Other than that we had a brief intro to cardiovascular physiology in the morning and embryology in the afternoon - nothing too taxing.  Overall the semester looks like a lot of fun with comparative anatomy, physiology (cardio, pulmonary, renal, gastrointestinal), virology, embryology, behavior, immunology, and more production medicine on the docket.

Christmas break was great between seeing family and friends, spending lots of time with the boy, and shadowing back at the home vet hospital for a few days.  It was a really weird transition to not be in a classroom each day or be studying in my apartment each night.  Vet school goes quickly but you really do feel as though you've been there forever after only a few days.

I also came back to Raleigh in time to work with the neurology department in the teaching hospital for a week.  LOVED it!  I'm really having the very serious problem of falling in love with some aspect of every new bit of vet med I encounter.  It's not helping the whole "figure out what I want to do with my life" issue.  Once again, the senior clinicians and residents were amazing and the fourth-year students were so helpful and great to learn from. 

Some of the top things I learned in neurology that week?

1) Neurologists get to actually perform surgery in addition to handling non-invasive cases!  Totally did not know that those procedures aren't done by the hospital surgeons.  I got to scrub in and watch several hemilaminectomies performed by the neuro residents.  These involved slowly drilling away the vertebral bone covering the spinal cord and removing the herniated vertebral disc out of a tiny surgical window.  Super delicate work!

2) Use of an MRI is commonly used in a full neuro work-up (yes, even in animals).  The imagery is absolutely amazing, and the use of different contrasting agents or exposures lets the physician visualize different things on different views.  The use of a single contrasting agent allowed us to perfectly see a hemorrhagic brain lesion in a seizing dog!

3) "Grand mal" is kind of an outdated way to describe seizures.  Who knew!

4) Phenobarbital and bromide, the two main drugs of choice for a lot of neurological conditions, are both over 100 years old and still going strong.

5) Neuro sees a lot of dachsunds.  A loooot.  The breed has vertebral discs that actually calcify by a young age, so instead of being springy and jelly-like and normal, they get hard and brittle and kind of unhappy.  Then they like to slip out into the vertebral canal and put pressure on the spinal cord rather than staying where they belong.  About 25% of the breed actually develops clinical signs from a herniated disc during their lifespan!

6) Orthostatic tremors are tremors that occur only when the patient is standing still and disappear when prone or moving.

7) I actually probably should remember all of those cranial nerves from anatomy - testing their function is one of the first steps of a neurological exam!  Poor functioning of a nerve could indicate a brain lesion in a specific location.

8) Both cancer and an infectious process (like meningoencephalitis) can show up on an MRI in a similar way.  At that point, performing a spinal tap to remove and then study cerebrospinal fluid (CSF) is a good diagnostic tool.

9) Loss of deep pain requires a very traumatic and complete lesion or injury and is associated with a much poorer prognosis for the patient.

10) Isolating where a neurological problem is occurring is very much like a puzzle or mystery.  Is it peripheral or central?  Brain or spinal cord?  Complete or unilateral?  Which vertebrae?  Which part of the brain?  Which nerve?  You have to use observation, tests, and sometimes a little diagnostic imaging to find the problem and only after it's found can you think about fixing it.  Pretty cool!

Tonight my goal is to get some paper reading done and finish my research proposal write-up for my summer work.  I've been putting it off out of sheer Christmas laziness, but that is definitely not an excuse anymore!

Cancer medicine thoughts

I love how Christmas-y it is right now!  It's gotten pretty cold here in Raleigh (it actually rivals Pennsylvania weather!), and we're expecting a dusting of snow tomorrow.  Naturally, everyone is freaking out at the news.  Plus, without classes I've had the chance to do Christmas baking, shopping, and movie-watching.  It's going to be really strange (and not so fun) going back to long days and hard-core studying in January...

Now that we're done with the fall semester, I've had the chance to spend the week with the oncology department in the teaching hospital.  LOVE IT!  There's a senior clinician on staff each week along with five oncology residents and three fourth-year students.  It's been a blast tagging along on appointments and treatments and getting some first-hand information on the whole internship/residency process from people who are currently in its midst.

Things I've learned this week...

1) On the whole, cancer medicine is NOT depressing!  Sure, there is always patient death or euthanasia to contend with, but that is true of any part of veterinary medicine.  "Cancer" is not necessarily an immediate death sentence.  Owners that bring their pets to the oncology service are able to get answers to their questions and often get additional time (often years) with their animals that they wouldn't have otherwise.

2) You don't really cure cancer as much as treat cancer.  For example, lymphoma is extremely common in dogs and cats and is one of the more common conditions that we've seen this week.  Even after pursuing radiation or chemotherapy for an initial diagnosis, remission is temporary and relapse is inevitable.  It's amazing to me how many owners are enthusiastic about pursuing treatment with the knowledge that a relapse will occur.

3) Golden retrievers and boxers are cancer machines.  I always knew these were breeds with strong cancer predispositions, but I think half of our patients this week have been one of these breeds.

4) Oncology is an attractive field to me due to the long-term interactions that you have with the client-patient unit.  Unlike some specialties where you stabilize or fix a problem without any additional follow-up, oncology gives the chance to be involved in a particular human-animal bond for years on end.

5) There are no right and wrong answers in treatment.  What's right for one owner isn't right for another, and what works for one animal may have no effect on another.

6) There's a lot of guesswork and extrapolation from human medicine and veterinary studies with small sample sizes (25 dogs in a paper is a decent study).  As a result, doctors in the field do the best they can with the information they have with little guarantee of efficacy.  For example, this week we completed a consult for a cat who had a lung lobectomy.  The owners wanted to know what they could do next to control growth of additional cancer processes.  The problem is, there is no solid or collected data about lung cancer chemotherapy in cats...so we advise, explain, and suggest things but always remind clients that nothing is known for sure.

7) All of those cell surface markers I learned in immunology are pretty important and can tell us a lot about the cell populations present in lymphoma and leukemia cases!

8) One of the first things that will happen with any new cancer patient is staging of the disease - where is it located and how far has it spread?  At our hospital that involves a CBC/Chemistry panel, lymph node aspirates (to check cytology in those locations), chest radiographs (to see if there is any pulmonary metastasis), and an abdominal ultrasound (to see if there is any other organ metastasis). 

9) Dogs are really, really resilient!!!  Just today there was a surgical removal of a fibrosarcoma from the chest of a dog who just started showing clinical signs this past week.  There was a golf-ball-sized piece palpable on the outside of the ribcage...and a cantaloupe-sized continuation of it inside the ribs, smushing the lungs and surrounding the heart and aorta!  The surgeons spent eight hours removing the mass and it was amazing to see this huge ugly, lumpy thing sitting in the biopsy tray after.  And 14 days ago, the owners had no idea it was even present in their pet!

10) Seeing dogs and cats that are living two or three years after their initial cancer diagnosis is pretty awesome.

All in all, I'm really loving my time with the service.  Can't wait for neurology in January!

Relaxed...

Honestly, the reason I haven't posted much recently is that there's nothing super-exciting going on!

Finals finished up last Wednesday, and it felt amazing walking out of school knowing I finished my first semester of vet school classes.  Can't believe that I'm 1/6th of the way through with my classroom work!  Everything turned out great - made all A's for my first semester!  Plus I got to enjoy Thanksgiving at home with family, Grandpa, pets, and boy without any stress about school!  Perfect!

Right now we're in the middle of our selectives blocks.  A lot of my classmates are doing some pretty awesome stuff - spaying iguanas, assisting with hospital departments and cases, learning avian pathology, etc. - but I elected to get the required business course out of the way.  Ugh.  It definitely reminds me why I'm not pursuing law or business school.  Soooo boring!  I mean, none of us are arguing that how to build practice value, negotiate contracts, hire/interview, or bookkeep is irrelevant or unimportant.  It's critical, and we know that.  But getting two straight weeks of lecture (7 hours daily) is brutal.  Can't wait for it to be over!

I also got the official go-ahead on some clinical work for Christmas break.  I'll be putting in a week with the oncology department as well as a week with the neurology department.  I can't wait to get a feel for what referral and specialty work is like.  Internships and residencies are still avenues I haven't ruled out, so getting an idea of how specialists operate and how their days flow will be really useful.

Next week I've got an ultrasound wetlab scheduled using goats and sheep, and I've also arranged a cookie exchange between members of our class.  It's awesome to not have to come home at the end of the day and study.  We can actually hang out, have fun, and enjoy each other's company.  Love it!  Heading to Pittsburgh for the weekend to see my favorite boy - and this time I won't have to get up really early or lock myself away to get schoolwork done!  Can't wait!