Word from the Wise

Here is a tip: Study Immunology....
Don't play Tetris instead.

You are welcome.

Some pictures...

I haven't posted pictures in a while. Here are a couple to go along with what has been going on.

Spring Fling 2012: Masqurade Ball

Challeng Cup Mascots - Stags, Elephants, Pheonixes, and Foxes

The Cup with The Silversmiths and the Mascots

R.I.P. Woody - May you have ALL of your 'babies' now! He sure loved a good squeeky toy!

Me and the Stag

Studying for Live Animal exam....

Feathery necklace <3 - Retail therapy! I will post more of the fabulous stuff I bought later...

Feathery headband <3

yup

Exam Time

Wow. 11 exams. 3 weeks. Then my first year of vet school will be over.
Hard to believe.

Ok so Monday (April 2) we had our histology bellringer then went immediately into the anatomy lab for our anatomy lab bellringer. It was 3 hours of torture. But I survived.
The Histo bellringer was not a 'final' but was our last one. We have had four over the course of the year. It was not cummulative, but covered immune organs, endocrine organs, kidney, and hematology. It was VERY hard.
The anatomy bell ringer was technically cummulative, but major focus was on pelvis and limbs because everything else was already tested on our winter midterm bellringer. The class avg was 78. So hopefully I did not do too poorly *fingers crossed*

Tomorrow is Live Animal Anatomy exam. We get 15 minutes infront of each a dog, cow, and horse. There will be 10 cards on a table, at each i have to pick 3 and answer the questions on them. Questions will be anatomical (and a bit clinical) but on a live creature. Things like, 'Point to the tuber coxae. What is it called in cattle?' and 'Show and tell me which muscles you could do an intermuscular injection in.' and 'Show me where you can palpate lymph nodes.' and 'where would you put your stethescope if you wanted to auscultate the rumen? cecum?' Not too hard, but it still requires review of our lab manual.

Thursday, Radiology. Bellringer style. 5 radiographs at 5 stations. We will have to hang them ourselves. Describe abnormalities, confirm normalties, describe boundaries and regions, state which structures you can't see on rads, etc.

Next Tuesday, Art of Veterinary Medicine (AVM). This is our communications class. We will be tested on the Calgary-Cambridge Guide (I posted about the CCG earlier!), what all of the Canadian and Ontario legislations due, roles of a vet, etc. Boring as manure, but hey, it'll be an easy one. *again fingers crossed*

Wednesday and Thursday (April 11 and 12) are our combined finals. Physiology and Histology. These will be super hard.... damn immunology!!!

16th - Health Management final (multiple choice!!!)
18th - Genetics (ew. we will be tested on our presentations... which sucks because in order to study, i have to read through all 24 project outlines and abstrcats that my class mates wrote)
19th - Clinical Medicine final (similar to the midterms)
20th - Biochemistry (our biochem prof got pneumonia half way through the course and the only other prof was on sabbatical so he recorded audio lectures for us... that means I have 12 hours of lectures to listen too and take notes from. super. and unlike the midterm, there will not be a nice bank of questions to practice on!)

Then I am done. So I am at 2 out of 11.

Other stuff on my mind:
- Boyfriend with Bronchitis - you know what men are like when they are sick :(
- Summer job schedule is not posted yet and I am trying to book dog sitting jobs and reception desk shifts. It is difficult not knowing if i will be on Days or Nights...
- Moving into a bigger room in the same house - trying to pack and clean/put winter clothes away
- Volunteering with the Birds of Prey still - not sure if I will be able to keep this up during the summer with such a full workload
- Easter weekend :) Yay leftovers! And I get to see my baby cousins!
- My uncle's dog recently passed away (R.I.P. Woody the Springer Spaniel)
- Lost Challenge Cup AND the intramurals finals for hockey... boo... At least our class won the spirit award! Now I am looking for some summer rec hockey to keep in shape
- My dog (Jesse) has a tumour on her back that the vet keeps having to lance and extrude material out of. I think it is in the hair follicle because chunks of hair come out. She takes it like an angel, never complains, but she is 14 and I know she will only take this for so long and then it will be time to make difficult decisions. :(

So much for such a little brain! Ha.

Ps. I found some more links to some very helpful resources!
Histology Lab and Lectures - http://www.vetmed.vt.edu/education/Curriculum/VM8054/Labs/labtoc.htm

Veterinary Consultant - http://www.vet.cornell.edu/consultant/consult.asp
(You can enter symptoms in and get a list of possible diagnosis OR you can search the symptoms of a disease!! Very cool! It will be really helpful in Phase 3 and 4!)

Immunology review on Youtube - http://www.youtube.com/playlist?list=PLA62C39CA82823B6D

Anatomy themed Sporcle quizes! - http://www.sporcle.com/user/ntrabbitguy/contributed
(Made by a peer in my class!)

Immunology resource by KUBY - http://www.whfreeman.com/Catalog/static/whf/kuby/

Objective Pathology (OVC Histology Slides) - http://images.objectivepathology.com/default.aspx?curfolder=%2fUoGuelph%2fOVC%2fVETM3120
(There is more than just histology - go to: http://images.objectivepathology.com/)

Radiology resource - http://vetmed.illinois.edu/courses/imaging_anatomy/index.html

Enjoy!

Just a Couple Online Resources

As I am up late studying for my practical exam tomorrow, I realize that there are TONS of online videos that are super helpful and I can post to you and not break the copyright laws of the University!

All of the following are from Youtube (the medical students BEST friend!!!):

Shotgun Histology:
http://www.youtube.com/results?search_query=shotgun+histology&oq=shotgun+histology&aq=f&aqi=g10&aql=&gs_sm=3&gs_upl=30578l36975l0l37317l17l17l0l9l9l0l115l844l3.5l8l0

Injection Sites and Methods:
Cattle - http://www.youtube.com/watch?v=Am-3L3IVQBs
Horse - http://www.youtube.com/watch?v=XSxegxets1k&feature=related

Giving Oral Medications to Large Animals:
Sheep - http://www.youtube.com/watch?v=nFrsBQWwepE&feature=related
Nasogastric in Cattle - http://www.youtube.com/watch?v=JuX5SKXEs4k
Oragastric in Cattle (fric speculum) - http://www.youtube.com/watch?v=xNDgCpisnKY

Blood Collection:
Cattle - http://www.youtube.com/watch?v=N2fy9CwYRDw
**** DO NOT use your teeth to uncap or recap a needle....
you will A) Prick yourself and B) Fail Clin Med....
Small Ruminants - http://www.youtube.com/watch?v=47tlmqXX3eE
Coccygeal Vein - http://www.youtube.com/watch?v=Ylfip7tolT0

Urine Collection:
Cattle - http://www.youtube.com/watch?v=lJ__wNhbWn0

Vitals:

 

Bovine (mature):

Rectal Temperature 38 - 39 °C

Heart Rate 60 - 80 bpm

Respiratory Rate 10 - 30 brpm

Equine (mature):

Rectal Temperature 37 - 38 °C

Heart Rate 28 - 40 bpm

Respiratory Rate 8 - 16 brpm

Ovine (mature):

Rectal Temperature 39 - 39.5 °C

Heart Rate 70 - 80 bpm

Respiratory Rate 12 - 20 brpm


Enjoy!

Large Animal Ward

Exciting news. I was officially offered a summer job at the Large Animal Ward on Friday! This is an amazing opportunity for me to gain some clinical experience. It is a full-time position over the four summer monthes; 12 hour shifts, 3 days on, 4 days off; alternating between days and nights. With my days off I plan to up my volunteering, hopefully with food animal producers learning on farm stuff. I am definitely lacking the practical hands on stuff, and now I have an opportunity to learn it. There is a very nice third year who has offered me a chance to come volunteer on her Dad's dairy farm for a week before she goes off on her externship. This opportunity/connection occured during a Food Animal Prof lunch talk held by the Bovine Club. SEE how IMPORTANT joining clubs is!!!!!

Exam weeks approach and I have my Large Animal Clinical Medicine exam tomorrow. We randomly select a poker chip with a prof's initials on it then that prof tells us to 'pick a cue card' which will have one of three tasks on it. So we have to be prepared for anything. Some examples of tasks may be to identify the type of feed in the bucket and tell who it gets fed to and why, do a full physical exam on the horse, demonstrate how to give oral medication to a cow, or safely and correctly tip a sheep.

Off to practice bovine restraint knots on the dog.... She doesn't mind! hahaha

Keeping Busy

Busy busy busy...
Between studying, class, and general life maintenance (cleaning, laundry, dishes, cooking, showering, etc.) I still have my volunteering and social comittee stuff going on. It feels like a lot of time is spent just answering and sending emails to people I need to contact and planning meetings and such. Crazy times. We are preparing for our big Family and Friends Day where the phase ones invite guests to come and tour the campus and have mini lectures given by our profs. Then we have Spring Fling, another Bar Night, and a Dog Wash that we have to plan. I like doing the computery stuff and the poster design but I am so picky with it that I spend way to long fixing sizes and colours...

Also, at Wild Ontario we are getting a bunch of new volunteers. We need to start their training and training is always a pain in the butt. I also moved to a new bird. I am now with Indian Jones the Red Taled Hawk. We are flight training him right now so it is  a nice treat to be on a bird with a higher level of difficulty.

ALSO... very exciting news...
I DID MY FIRST RECTAL PALPATIONS LAST WEEK!!!!!!!!!
This seriously is really great news! I was volunteering with the Ruminant Field Services here at the OVC and we got to go do some pregnancy checks on a milking herd. Palpation is a skill that needs to be developed and in school we don't learn it until phase two! It's great to get some extra practice and have some one on one instruction from a prof. We also got to collect urine from a few. This is also a skill worth practicing. Collecting bovine urine is NOTHING like chasing a dog with a laddle or doing cystocentisis on a cat. You have to rub the escutcheon (the skin just ventral of the vulva) without getting your toes stepped on while she postures.... and the little tiny collection cup means that you get your hand very dirty.... I love large animal medicine :)

Calgary-Cambridge Guide

I lay awake here because the fire alarms have gone off twice tonight and the whole house smells like burnt popcorn. SO mad at my house mate... He is very inconsiderate and very fat and obnoxious.

Now that that is off my chest, I can use this awake time to bring you the AVM stuff I promised. The following is the Calgary-Cambridge Guide to becoming a better communicator in veterinary medicine. Some of it feels silly, but it is actually much harder to incorporate these when faced with the situation head on. We have had a chance now to try this in class with fake clients.

Our simulated client interviews are taped so we get the "pleasure" of having to critic them. In first year we get easy ish ones, just trying to give empathy and praise to the client and try to get a bit of a rapport going. We also have a student coach and a proffessional coach with us to help us through the interview. The nice thing is that we can pause resume and rewind if we are unsure. I feel that I prepared just enough, any more and I would not have been able to handle the "curve balls" they throw at you half way through. I think I did well, but I guess we'll see when I get my tape back.

My first scenario was what we refer to as "The Crazy Rabbit Lady". She was so angry and unmoving. She shook her leg, and crossed her arms and only looked at me when she vented about her ex-husband. It was terrifying. However, I learned a lot. She was upset that she had to care for a smelly rabbit that her two young daughters loved and that her ex-husband gave them for Easter. I had to give her lots of sympathy and ask about her daughters, then let her shred her ex-husband apart verbally before I got anywhere near to asking questions about the rabbit. So crazy...

My second was total opposite. This was a woman who was super chatty and wanted to ask some questions about declawing. For her I had to let her ramble for a couple minutes then change the subject to her cat gently and fluently as not to offend her and ruin the relationship we were building. She wanted to talk about her daughter too and she clearly missed her as she was at university. It made her feel bonded to talk casually. Then I had to let her know that she has some surgical and non-surgical options to deal with her husband's wish to declaw the cat (which she was opposed to). She liked knowing that she was not the only one who felt this way and I praised her for coming in to talk about it so she got all the information to make a proper decision. I actually felt nervous when she wasn't yelling! hahaha

Clearly these were made up and performed by trained actors. The characters were well planned out and actually felt like real people. My class mates expressed some upset that we have to do this exercise but I think it's good that we got the practise. More clients are "difficult" then are easy. It normally is a struggle to get info out of them and build a good relationship with them. There is ALWAYS outside, personal issues that will be affecting them and their pets so as clinicians we will see lots of "crazy ladies" during our careers. I am glad that we get to do this again next year, i just don't want to have to write up a silly report based on my recording....

Before I leave, I would like to say that if anyone out there is reading this and is prepping their vet school applications, please contact me with any questions kmarinac!uoguelph.ca

So here it is, the Calgary-Cambridge Guide:

Step I: Start the clinical interview

Skill 1 – Establish rapport with the client

• Warmth in tone of voice and a smile à connect with client
• Greet client(s) before patient(s), but always both
• Shake hands (if possible)
• Introduce yourself by name and role
• Generally formal mode of address (Mr., Mrs., Ms., etc.) until invited to do otherwise by client
• Find something in common to start off interview (e.g. weather)
• Squarely face the person (whether you are sitting or standing)
• Open your posture and lean towards the person
• Eye contact as appropriate

Skill 2 - Identify reason for the consultation

·         Ask appropriate opening question

·         Listen to client’s opening statement

·         Open ears; close mouth

·         Resist the urge to interrupt the client to clarify a point à make a  mental note to come back to it

·         Don’t just focus on the first issue the client brings up - they may have a ‘list’

·         Establish an agenda to confirm you understand client’s needs and expectations

Skill 3 – You use appropriate non-verbal behaviors

• Provide appropriate eye contact, facial expressions, posture, vocal cues (‘minimal encouragers’)
• Use notes, records, computer appropriately

Skill 4 – You reinforce rapport

• Acknowledge client’s views and feelings

·         Empathize with the client 

Skill 5 – You involve the client

• Explain what you are doing            
• Share your thoughts about what you are finding

Skill 6 – Explore the problem

·         Use open or closed ended questions when appropriate

·         Clarify/paraphrase

·         Summarize interview up until now

Skill 7 – Work to understand the client’s perspective

• Determine client’s ideas and expectations
• Assess effect of problem on client and patient

Skill 8 – You provide timely & appropriate information

·         Ask what client already knows & what other information they want to know (“start where the client is at”)

·         Explain at appropriate times

·         Give information in manageable chunks and check in with client

• When will results of the diagnostic tests be available?
• What are the risks of the disease and the treatment?
• What are the options for treatment?
• What are the costs?
• What is your recommendation?

Skill 9 – You share decision-making with client

·         Share your thinking

·         Negotiate a plan

·         Check for acceptance and concerns

·         Client is educated

·         Client feels that he or she is heard and understood

·         Joint decision making emerges from the conversation

Skill 10 – You summarize and check in

·         Recap interview briefly and clarify plan

·         Do a final check to see if client willingly agrees to plan