Photos From A Sunny Weekend

It was perfect weather this weekend again. I think it should be considered a sin if you do not spend as much time as possible outside on a weekend like this. I spent quite a bit of time studying outside and took my camera everywhere with me. Below is some typical Ithaca scenery at dusk:


I also spent some time Sunday visiting a nearby farm to castrate piglets, deworm alpacas and socialize with my classmates and the owners of the farm. A good time was had by all.


At my pet sitting job there was a very inquisitive fawn who seemed to want to know what I was all about. There is a huge problem with the overpopulation of deer in Ithaca (and most of New York state) and I don't generally stop to fawn over them but this one's misplaced curiosity did seem remarkable.

Finally, on Sunday I went on a long walk with some of my classmates to re-trace the steps of our poisonous plants walk that we took on Tuesday morning. I saw the most amazing oak tree, so big it didn't fit in my camera frame. I also enjoyed getting to use the close-up function on my new camera from my dad to take photos of flowers.

Below: Touch-me-not!


Pokeberry:

This was their example of a foxtail. None of my classmates could figure out how it could embed itself in a dog and travel through the flesh. Not exactly what the foxtails I saw in California looked like. I did tell my classmates I had seen them in every orifice and body part over the years but they seemed skeptical that a plant could burrow through tissue...

I forget what this one is called...

Castor bean.
Milkweed close-up, I believe that is an egg laid by a butterfly! (Thanks SyracuseSurrogate parents for helping to hone my eyes for these things).

Later I saw a monarch resting on some corn.

I believe this is a butterfly belonging to the fritillary family.

And my roommate's daughter found another neat bug, a small, almost translucent grasshopper of some kind.

Lindy The Lovely Lady Going Downhill

Last night as I was studying at my desk, Lindy curled up on my lap and rested her head on my desk. Very sweet. It took some encouraging to get her to settle on my lap as usually she likes to stand on my keyboard (I think it is her way of getting my attention no matter what I might be trying to do). Ignore the still unfolded laundry in the background.... (sigh)
Bad news is that I returned from my summer in California and North Carolina to find Lindy in significantly worse shape than when I left her. She'd lost a lot of muscle mass, was much weaker and had a markedly decreased appetite. I didn't help matters by basically ignoring her while I was busy on my emergency rotation (I didn't give her her phophate binder or other medications except for the fluids during that time).

I'm sure my classmate who had her took excellent care of her, she's just that kind of person-- super sharp and extremely responsible. Lindy was bound to take a turn for the worse at some point. I just feel bad that it happened while I was away.

So now I'm giving her fluids morning and evening (which she hates, although she never objected to getting fluids in the evening alone) and increasing the amount of phosphate binder that I give her.

I have 5 (!) water bowls in my room, including a fountain with flowing water, and I bought a foot stool since she is too weak to jump up on my bed.

For those clinicians out there, her creatinine is now 5.3 (before it was 4) and her BUN is 60 and her phosphorous is 9.5 I don't know how long she can live like this but her appetite has improved so as long as she is eating and wants to cuddle with me at night (she purrs like a madlady) I am going to keep treating her although I wonder about her quality of life since mainly she spends her day resting on or under my bed.

Wonderful Weekend

Friday and Saturday were picture perfect days. I took a drive along Cayuga lake (above). The sign below struck me as quintissential Ithaca:

Then I went to work, albeit uncharacteristically late. I got to play with a very wiggly pittie puppy belonging to one of the residents:

On Saturday I went to visit SyracuseSurrogateParents to celebrate EB's birthday in lieu of her (she's in Durham). I was memerized by their raising of Monarch butterflies. They are part of MonarchWatch and dedicated to trying to reverse the decline in the Monarch population. It is a labor intensive endeavor that involves growing milkweed, picking leaves that have eggs on them, examining the leaves and collecting larvae, transferring larvae to aquariums when big enough, cleaning and changing out the substrate in the aquariums every other day, collecting enough milkweed to feed the caterpillars from local habitat, monitoring when the caterpillars go into the J-form and become a chrysalis, monitoring the chrysalises for hatching of the butterfly and keeping track of the whole process via spreadsheet!
Below is an escaped caterpillar crawling on a pan containing leaves with eggs on them:

More leaves with eggs:

Caterpillars munching on milkweed:

Chrysalises and a lone caterpillar in the J-form preparing to form a chrysalis. Apparently once the tentacles go limp, the caterpillar unzips and a green goo appears which hardens into the chrysalis. All of this happens relatively quickly, in about ten minutes. I spent some rapt time watching the caterpillars hanging in J-form but never got to see one unzip and shed its skin! Maybe next time...

I find it mind-boggling that the caterpillars completely digest themselves and are resurrected as butterflies. Very cool but also kind of creepy. Certainly very, very bizarre. Wonder how it all evolved.

And here's a photo of the whole set-up:

As usual, SyracuseSurrogateParents fed me delicious meals with ingredients freshly picked from their enormous garden and provided hours of interesting conversation.

I was sad to have to return to Ithaca on Sunday but I had lots of studying to catch up on as I didn't do nearly enough work last week. It's not like me to procrastinate but I was pretty burned out after my emergency rotation and didn't work as much as I usually do last week. I spent Sunday evening studying with my awesome study group and all of today cramming for my first quiz, which I just finally took and submitted (they are online quizzes so you have until midnight to complete them).

I'm glad to have that out of the way but that leaves a whole set of learning issues tomorrow. And as I have class starting at 7 am and ending at 3 am I have to head to bed. I'm chronically weighing my need for sleep against my desire to write and post on my blog. Unfortunately, sleep trumps all else and I'm always pressed for time.

Talking To My Sister and Niece

My sister called me this morning on Skype and I took some photos of her and my niece. It was nice to see them, even if not in person. My niece is changing so rapidly, it amazes me how fast kids grow!

From Clinics To Classes With No Break!

It's been absolutely beautiful the past few days. I took the photo above of the moonrise tonight as I was leaving the vet school library (I stayed till it closed at 8 pm, darn those summer hours as I had tons more work left to do and checked out a huge stack of books overnight to use at home).

Below: A walking stick my landlady found tonight. First time either of us had ever seen one outside of a book or a museum.

Below: Photo I took driving along route 79 yesterday. Typical upstate New York scenery.

I've wanted to write much more than I have lately but I've been finding it hard to make time to get a good 8 hours of sleep and I know I have to make sleep my priority in order to survive this year. Hopefully I will find time to write more soon. Going straight from clinics to classes without even a day in between has knocked the wind out of my sails. And my room looks like it has been hit by a tornado-- that's how messy it is. I haven't even folded my laundry that I did three days ago (maybe I shouldn't admit to that:)

I got a fortune cookie at the catered Chinese lunch for the first years today that said:
"The stars appear every night in the sky: All is well."

And so it is. The stars appear in the night, the moon rises, and though hectic, all is indeed well.

Welcome To Clinics: It's NOT Personal

I'm nearing the end of my emergency rotation shift. Before I even started, I was briefed by one of my classmates who had done the emergency rotation earlier in the summer. His advice, "Don't take anything personally." Amen. My new motto for clinics is, "It's NOT Personal."

I think I did pretty well not taking anything personally up until today. Maybe it's because it's my second to last day and I'm tired. Maybe it is because all hell just broke loose and we got in a bunch of patients at once. I don't know.

I did see a bunch more interesting cases and some more "routine" type emergencies such as:
allergic reaction
blocked cat
more lacerations

Some of the interesting cases:
A dog with a foreign body that perforated and had most of its intestines removed but did remarkably well following surgery only to perforate again the following day. Very sad.

A dog with regurgitation that is likely focal myasthenia gravis.

A complicated post-op sepsis.

I wish I had had time to write more about this rotation but it just flew by and I had so little time to sleep to start. Sigh.

First Day Emergency Rotation

Wow, that was a crazy thirteen plus hour shift! I still love emergency medicine.

We saw a lot of classic emergencies--
severe heat stroke
severe rodenticide toxicity
possible pancreatitis
possible seizuring cat
HBC (hit by car) dog
cat with respiratory distress (unknown etiology)

And perhaps the most fascinating and puzzling case of the evening-- a cat that presented with blood all over her face, thorax and paws and continued to drip blood from her mouth. The owners did not know how the injury occurred as the cat had been outside in a closed in area.

QATs (quick assessment tests) showed anemia and the resident was worried it could be due to cancer or secondary to renal failure. But when we sedated the cat to do an oral exam, the ventral aspect of the tongue had a huge laceration. I've never seen a lingual laceration even close to that bad-- the lingual artery was completely transected. I imagine that it is likely the cat got its tongue somehow caught on the screen and ripped it open. However, given the severity of the laceration, it seems likely that loss of blood was the primary cause of the anemia, which is good in a way because it is more easily fixable than cancer or renal failure (and the azo stick was normal).

OK, I have to be back at noon tomorrow and it is 2 am now, so I'm off to bed.

Update: This cat came back a few days later and was sloughing off parts of its tongue and had to get a feeding tube. Very sad. The wonderful owners were dedicated and continued to treat so I think the cat will probably do well in the end. I certainly hope so.

Back From AVMA (Had A Blast), Whale Sharks And More...

Above: Me with a palomino Belgian named Butter.

I'm going to have to finish this post up later since it is so late, so check back tomorrow....