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The Lost Vet Tech Journals (very long)

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Mischief - 12 Mar 2005 00:57 GMT
No, I'm not really lost, I've just been really busy.  I have lab
reports to write up, a senior project to work on, a big test to study
for, the list goes on and on.But here's an update of what's been going
on in my life.

The beginning of this entry is a rant.  A rant about one of the
employees I work with.  I'm sure I've mentioned Mike, or Mike the
Schmuck as I call him under my breath.  Mike has been in this field for
15 years.  He's work at the clinic I work at for 3 years and I do
admit he does know his stuff.

But he has got to be the BIGGEST LOSER I have ever EVER met.  (and I
know this is the internet, but if by some chance he reads this, I
don't CARE)  Mike just turned 36, and since the day I started, has
been very 'close' friends with this brat I also work with, who only
recently turned 18. (They are apparently not dating but they are ALWAYS
talking when they are together and nothing gets done) He's loud,
rude, obnoxious, loves to sing songs at random very loudly and off key
in an attempt to gain attention.  He also has this extremely large beer
belly so the scrub pants don't fit him very well and you normally
will see his butt crack at least once during the day.  In the 11 months
I have worked, there have been at least 3 instances where he has left
for his lunch break and failed to come back, and he didn't even make
a phone call to tell us what was going on.  I remember one time he
didn't come back and you know what his excuse was?  "I ran out of
gas."

You ran out of gas and for the rest of the day couldn't find a phone?
I know that s*** happens to all of us, but you couldn't call?  "I
didn't have any money."  Ever hear of calling collect?  Sheesh!!   I
mean if it's a one time thing, I think any boss would be
understanding, but THREE TIMES?  Last Saturday, he was supposed to come
in at 8 am.  He didn't show up.  Me and the rest of the staff are
wondering where he is, and finally a little after 9 one of the
receptionists came in and said Mike was on his way.  Mike NEVER showed
up.  I offered to stay and help out.  So I ended up working from 7 am
to 6 pm.  I got overtime, but the entire day, Mike never called ONCE to
explain anything.  I asked him casually on Tuesday what had happened
and he said something happened with his mother.  I'm sorry, but I
don't believe that.  If there really is a family problem or any
problem at all, you still need to call and at least explain a little
bit.

Now some of you are thinking, "Why is this guy still working?  Why
hasn't he been fired yet?"  Believe me, there are about four of us at
the clinic that are wondering the EXACT same thing.  He is close
friends with the Vet Tech supevisor, so he manages to charm his way out
of everything.  Even the head doctor seems to let things slide with him
and it PISSES ME OFF every time.  And I can't do a THING about it.  I
can have a conversation with him and work with him if necessary, but I
hate his work ethic and don't trust him any farther than I could
throw him.

The only thing I get from Mike is how NOT to act as a Vet Tech.  I have
just been sitting back and just waiting for him to burn his bridges and
get his comeuppance.   Which WILL happen one day......

Okay enough ranting............

Tinta seems to have recovered from her URI, but we can't let her out of
her cage yet.  In the cage next to her is Elvis, a DLH gray and white
kitty, who came from a different shelter, and also came down with a
URI.  As far as I know, Tinta is not on any more medication, but Elvis
is getting Clavamox pills.

BTW, I wish that all cats were as easy to pill as Tinta.  I scruff her,
stick the pill behind her throat and she just goes *gulp!*  Me and my
friends are like, "Damn it, why can't ALL cats be that easy?"

We are doing surgery labs this semester in our Clinical Procedures
class.  We do a spay or neuter every wednesday and everyone
participates.  There's about 12 of us in each lab, and two labs.  The
entire procedure is divided into 12 tasks and we rotate every week

We had one last semester too and at that time my task was #13,
post-operative recovery. I keep an eye on the animal once he's taken
off the anesthesia and check his vital signs every 15 minutes. Well,
our cat being neutered was an 8 month old tabby named Kit Kat. Well
after the first 15 minutes, he tried to bite me as I took his vitals.
15 minutes later, he was still woozy, but he screamed and jumped up
about 6 inches when I tried to take his temperature.

"Uh, Dr. Grisham? I think the cat's definitely awake."

Last Wednesday, my task was #4, Anesthesia Induction.  The official
definition is that I calculate the amount of drugs that is to be used
on the animal and I inject it into the medial saphenous vein.

The short way is that I take a syringe with a "cocktail" of drugs and I
knock the cat out  :)  hehehehehehehe

Now the medial saphenous vein is the femoral vein on the inside of the
leg, and it's only about 2 mm wide.  When it's held off you can see it
bulge up.  Think it would be easy to hit?

If I was at work, I probably would have had an easier time doing this.
But I'm hunched over this cat with my teacher Dr Grisham at my elbow
watching my every move, my other teacher Liz at the head of the cat
ready to help the next student with the endotracheal tube and she's
watching me.  And ALL my classmates are crowded around watching me too.

Oh, noooooooo pressure....................

I've got 0.6 cc of a mixture of Ketamine and Valium and I need to put
it into this cat.  (Wouldn't it be great if you could just hit the
animal over the head with a mallet like in the cartoons?)  I uncapped
my needle and I went to make my stick.  Then I quickly recapped my
needle and shook out my hand because it was shaking.

Then I go and make my stick.  I make it at a 20-30 angle to the vein
and by all rights I SHOULD have hit it.  It was pretty superficial so I
didn't need to go in very far.  So I aspirated back on the plunger.  If
I saw a flash of blood, I was in the vein and could continue with the
injection.

I saw nothing.  I would reposition the needle ever so slightly and try
again.  I could see a tiny bubble moving back and forth but no blood.
Dr. Grisham is talking at my side giving me tips but I still can't
see anything.  Finally she said to pull out and we would try again.

I was dripping with sweat.  I managed to wipe my forehead on my scrub
top and got ready to try again. Again I made my stick, and again I
aspirated back.  And again I saw NOTHING.

I reposition the needle, and Liz and Dr. Grisham are giving me advice.
Suddenly I see a tiny flash of red.  Did I hit it?

No, the flash wasn't big enough and blood wasn't flowing into the
syringe when I aspirated.  I started to see a tiny lump form underneath
the skin near where I had made my stick. I had hit the vein, but I had
gone right through it and it was forming a hematoma. (Don't worry, it
will heal on its own) I pulled out again and sighed.

Now we are to keep trying until we get it right.  I was frustrated that
I couldn't hit this tiny vein cause it was RIGHT THERE.  My needle
was missing the vein by scant micrometers.

I wiped the sweat from my brow, again I'm nervous and frustrated and
I said, "I can throw a 1 1/2 somersault from a diving board 12 feet
above the water, but I can't hit the STUPID VEIN!!"
Grrrrrrrrrrr..........

Alright now, third time's a charm they say.  I make my stick and
aspirate back.  I see nothing.  So I sloooooooowly pull the needle back
to re-adjust when I see a flash of red.  I aspirate back the plunger
and blood flows into the syringe.  Hooray!!  I'm in!!

But that's NOT the end of it.  See when I'm at the clinic, once you
are in, you depress the plunger and inject the drugs into the animal.
It's over in a few seconds.  But can I do that?  Oh nooooooooooo.....

My classmate Shirley has the job of placing the endotracheal tube and
she can't do that until the animal is sufficiently anesthetized.  So
I'm supposed to inject the drugs a 0.1 increments and she checks the
cat's jaw tone and reflexes.

I start to depress the plunger, but I realize that my syringe is turned
so I have to CAREFULLY turn the syringe around so I can see the
numbers.  I inject 0.2 cc of the drugs and then I have to wait.  I'm
just barely in the vein and I'm supposed to hold still??  "Shirley?
Talk to me, now, what's going on?"  "Hang on a moment, Kristi,
we're checking....."

Have you ever tried to hold a needle and syringe perfectly still in a
vein only 2 mm wide?  Believe me the LAST thing I want is to have to
lose this vein.  So I held as still as I possibly could and yes, I'm
still sweating,

Finally I get the go ahead to inject more drugs.  This goes on until
finally all of the drugs are injected.  I let out a HUGE breath and
felt my knees go weak.  But I'm STILL not done yet.....

I have to grab my stethoscope and monitor the cat's vital signs until
Shirley has the endotrachael tube place and hooked up to the anesthetic
machine.  I'm still on this 'high' from the entire experience,
and I'm trying to listen to the cat's heartbeat and count it.
Fortunately Shirley got the tube placed on the first try, and I could
then turn over patient monitoring to another student.  I was finally
done......

WHEW!!!!!!!!!!  I took a step back from the table and my classmates are
patting me on the back.  I wanted to scream out " I am SO glad that
F****** task is finally DONE!" but I can't because it's
unprofessional and we get fined a dollar for every time we swear.
(Last semester I ended up paying $7, I've been quite good this
semester)

Man, that was difficult.  I'm sure had I'd been at work, I
wouldn't have had THAT much of a problem.  It was a mixture of
nerves, all my classmates and teachers watching me and lack of
experience that did it.  I was just glad that I finally had succeeded
and that it was over.

After the surgery was done we drew number to see what task we would do
next week.  I pulled #12, which is Surgical Assistant.  I get to scrub
in with Dr. Grisham, put on the surgical gown, and have to LIMIT my
movement to maintain sterility.  I get to hand her the instruments
during the surgery, and I get a chance to suture up the animal.
Yikes!!!  Dr. Grisham is very knowledgeable, and she's one of the
those instructors that you highly respect and pray to God that you
don't make an idiot of yourself in front of her.

I plan to go through ALL my notes so I know which instrument is which
and so I don't look like a complete fool.  (Actually Dr. Grisham is
pretty patient since every week a new student has to go through this)

Okay, that's what's been going on with me.  I might be able to put
in another entry, but right now I have a lab report to try to write.

Thanks for you patience,

Kristi
Karen - 12 Mar 2005 01:33 GMT
But how is your EYE??  :)
Mischief - 12 Mar 2005 01:57 GMT
Oh, my eye is doing much better thank you

In fact I was able to dive in a swim meet today.

I was quite bummed out because even though my dives looked good during
warmup, i got low scores.

There's a big invitational next week, so I hope I can do better then.

Thanks for asking

Kristi
Cheryl - 12 Mar 2005 04:09 GMT
[...]

> The only thing I get from Mike is how NOT to act as a Vet Tech.
> I have just been sitting back and just waiting for him to burn
> his bridges and get his comeuppance.   Which WILL happen one
> day......
>
> Okay enough ranting............

Kristi, you're rant is valid of course. There are going to be many
people who you will feel justice doesn't serve them quick enough.
But you're also right that one day... Hang in there.

[...]

> BTW, I wish that all cats were as easy to pill as Tinta.  I
> scruff her, stick the pill behind her throat and she just goes
> *gulp!*  Me and my friends are like, "Damn it, why can't ALL
> cats be that easy?"

More purrs for Tinta!

[...]

> Last Wednesday, my task was #4, Anesthesia Induction.  The
> official definition is that I calculate the amount of drugs that
[quoted text clipped - 3 lines]
> The short way is that I take a syringe with a "cocktail" of
> drugs and I knock the cat out  :)  hehehehehehehe

Now, THAT was a maniacal laugh!!  ;)

> Now the medial saphenous vein is the femoral vein on the inside
> of the leg, and it's only about 2 mm wide.  When it's held off
[quoted text clipped - 11 lines]
> I've got 0.6 cc of a mixture of Ketamine and Valium and I need
> to put it into this cat.  

I thought Ketamine = bad?

(Wouldn't it be great if you could
> just hit the animal over the head with a mallet like in the
> cartoons?)  I uncapped my needle and I went to make my stick.
[quoted text clipped - 6 lines]
> back on the plunger.  If I saw a flash of blood, I was in the
> vein and could continue with the injection.

[...]
Don't feel bad. I've seen experienced vets have problems with
sticks. I've had a vet who was doing subQ fluids for my RB Marley
and it all spilled out the other side of the "tent".  Practice
practice practice!!!

> Okay, that's what's been going on with me.  I might be able to
> put in another entry, but right now I have a lab report to try
> to write.

Good luck with your studies and thanks for the story!!

> Thanks for you patience,

I enjoy them!

Signature

Cheryl

Mischief - 12 Mar 2005 04:41 GMT
I thought Ketamine = bad?

ketamine can cause muscle rigidity and can be dangerous with animals
with history of seizures, but compared to other anesthetic drugs, it
doesn't depress the heart rate or breathing.  Normally it's mixed with
a tranquilizer or sedative to aid in muscle relaxtion and to prevent
excitement during recovery.

Of course it's also a controlled substance and is known as Special K on
the street.  It even can be absorbed through mucous membranes

Ketamine and Valium is a popular mix and is usually preferred in most
practices.

Kristi
Cheryl - 12 Mar 2005 05:29 GMT
> I thought Ketamine = bad?
>
[quoted text clipped - 13 lines]
>
> Kristi

I've read some about Ketamine and that was what caused Shadow to
almost die when he had a biopsy and a feeding tube (PEG) inserted.
I guess I just cringe when I read about its use. He had an EKG
after the near-death experience and the results of that said to use
a different anesthesia for surgery.  

Signature

Cheryl

L. (usenetlyn) - 12 Mar 2005 08:17 GMT
> I thought Ketamine = bad?
>
[quoted text clipped - 3 lines]
> a tranquilizer or sedative to aid in muscle relaxtion and to prevent
> excitement during recovery.

Vets still use it because it's cheap.  IME, it's usually mixed with
acepromazine and atropine.

> Of course it's also a controlled substance and is known as Special K on
> the street.  It even can be absorbed through mucous membranes
>
> Ketamine and Valium is a popular mix and is usually preferred in most
> practices.

We only used ket/val on cats that couldn't handle ace.

-L.
Howard Berkowitz - 13 Mar 2005 17:22 GMT
> I thought Ketamine = bad?
>
[quoted text clipped - 9 lines]
> Ketamine and Valium is a popular mix and is usually preferred in most
> practices.

Probably the most common mix in human medicine is ketamine and
droperidol, often with additional drugs such as nitrous oxide and
fentanyl.

Is etomidate used in veterinary practice?  It's replaced ketamine for
many quick procedures, and seems to have lesser psychotropic effects.  
Propofol is also used.

There's a great trick that is used in pediatrics, although there would
have to be chemical and dosage form for cats:  fentanyl-laced lollipops.
Give the lollipop, and you wind up with a gently semiconscious child in
a bit. The fentanyl may be enough to do quick painful procedures such as
a dressing change, or it will put the patient in a good state to accept
additional drugs.  Of course, putting in an IV on a fentanyl-zonked
patient is unlikely to be noticed.
Cheryl - 14 Mar 2005 00:41 GMT
> There's a great trick that is used in pediatrics, although there
> would have to be chemical and dosage form for cats:
[quoted text clipped - 4 lines]
> drugs.  Of course, putting in an IV on a fentanyl-zonked patient
> is unlikely to be noticed.

With cats, they use a fentanyl patch. Shadow (RB) had one after a
surgery to remove the flange of a PEG tube when the vet couldn't get
it out. Long story. They used a dog-sized tube and flange and when it
wouldn't pull out through the abdomen as it was designed to do, the
doctor couldn't pull it out through his throat, either. Too large to
fit. I cringe whenever I think about this.

Signature

Cheryl

Marina - 12 Mar 2005 04:20 GMT
> Okay, that's what's been going on with me.  I might be able to put
> in another entry, but right now I have a lab report to try to write.
>
> Thanks for you patience,

And thank you for the journal. I was curling my toes until you got the
needle right. Phew! Well done, Kristi.

Signature

Marina, Frank and Nikki
marina (dot) kurten (at) pp (dot) inet (dot) fi
Pics at http://uk.pg.photos.yahoo.com/ph/frankiennikki/
and http://community.webshots.com/user/frankiennikki

O J - 12 Mar 2005 10:18 GMT
---------------------<snip>----------------------
>Man, that was difficult.  I'm sure had I'd been at work, I
>wouldn't have had THAT much of a problem.  It was a mixture of
>nerves, all my classmates and teachers watching me and lack of
>experience that did it.  I was just glad that I finally had succeeded
>and that it was over.

I used to have to do some pretty delicate work with hair-sized fiber
optics.  It took a while before I could do the assorted jobs with
someone watching.

I later "experimented" on two colleagues.  One I told that a
particular job was very delicate and you could see his hands start to
shake as he brought them together to connect the fibers.  I then let
him in on the fact that he was doing just fine.  Another I told that
it was much easier than in school, just a piece of cake and his hands
never shook at all.

Yes, I was a big meanie, but as I did most of the teaching for our
gang of eight splicers, I wanted to find out how much of the job
depended on the attitude of the teacher.

Regards and Purrs,
O J

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