Okay, on March 16th, during my surgery lab, I got to be surgical
assistant to my professor Dr. Grisham during a cat spay.

As I've mentioned before, everyone in class participates in same way
with the spay.  For some of us, we are placing catheters or
endotrachael tubes for the first time.  But we get to do it with all
our classmates watching.

I admit in my past vet tech journals I was nervous when I had to induce
anesthesia.  Trying to hit a vein only 2 mm wide is NOT easy.  This
job, however was really nerve wracking.

Dr. Grisham is a great professor.  She's also a mother and has that
"no-nonsense" tone to her voice.  She's a person I highly respect and
therefore when I HATE messing up in front of her.  She's one of the
last people I would want to disappoint, so I put a lot of pressure on
myself to do well in her class.  (I know, not a great strategy, but
putting pressure on myself happens to be a double edged sword I've
dealt with all my life, and that's another story)

I originally wanted to be an actress and perform in front of hundreds
of people.  My brother and sister both know me as the crazy one.  I
currently am on the springboard diving team and throw myself off a
diving board 12 feet above the water.  My whole life has been full of
nervous, adrenaline rushing events, which I practically throw myself
into.  But I will always remember this experience as one where I was
the most nervous.  All I had to do was hand instruments and place
sutures, but I was a nervous wreck the entire lab.  I went into the lab
with a few goals; Don't drop anything, don't curse, and don't
make an idiot of yourself.  Two out of three isn't that bad.

First I had a hard time with the scrubbing.  The brush really hurt and
I had to keep scrubbing my skin.  10 times from the palm to the elbow,
10 times from the back of the hand to the elbow, 10 times on both sides
of the arms, then repeat to the other arm.  Then rinse and scrub again.
 owowowowowowow!

All the while trying not to touch the sides of the sink and trying to
rinse properly.  I would put my arm and move it under the stream of
water, but Dr. Grisham had to keep telling me to keep my arm in the
sink and not pull it out.

My next hurdle was getting the gown on.  I picked up the gown and let
it fall and unfold in front of me.  I was to find the armholes and work
my hands and arms into them.  This part I had trouble with, because as
I tried to extend my arms through the sleeves, I almost contaminated
sterility by hitting the mayo stand with the sleeve.  So I had to try
to put the gown on the best I could making as little movement as
possible. Trying to put on a gown without using your hands and keeping
your elbows at your sides reminded me of a twisted party game. Like
passign the orange or something.....

I was trying to get it on, and yet I was struggling and I was trying
not to break sterility, and keep my cool at the same time. Fortunately
the circulating nurse came and helped pull on and tie the gown.  Then
she opened up the sterile gloves and I had to keep my hands inside the
gown cuffs and put on the gloves.

You pick up the glove with your hand, still in the sleeve and you pull
it on.  Then you wiggle your fingers through so they emerge from the
sleeve and into the glove.

I challenge all who read this to put on a long sleeved shirt, leave the
hands in the cuff and then put gloves on top of it so  the top part of
the sleeve is inside the gloves.  You can't use your fingers.

It's NOT easy.

I remember having a hard time with this when we learned about gowning
and gloving, and this time was no different.  Somehow I managed to get
my fingers into the gloves.  Then I clasped my hands and told myself,
"DON'T MOVE."

I had reviewed the instruments ahead of time, so I was pretty familiar
with them. I was able to recognize a hemostat from a spay hook, I knew
what a Rochester Carmalt was, and I identified the towel clamps, but
the correct answer was "Backhaus towel clamps"  ooops....

There was some down time, so I started to relax and then Dr. Grisham
made a comment about the lack of caps for the rest of the class.  I
started to answer and point to my cap when she yelled, "DON'T DO
THAT!!!" I had almost broken sterility with that simple gesture.  I
felt so horrible.  I thought I was going to cry.  For a split second I
was afraid that Dr. Grisham was going to stop everything and make me
scrub all over again.  But she calmed down and just said, "Don't do
that again.  Don't touch your cap."  Honestly I thought I was just
pointing but apparently I had touched.

(Technically if I really did touch my cap, the only thing contaminated
would have been the gloves and all I would have had to do would be to
re-glove, but the point was I had broken sterility, a big no-no)

Somehow I managed to gather myself and we managed to start the surgery.
I was fascinated to be able to see a cat spay this close, but at the
same time I had to pay attention to which instruments Dr. Grisham
needed.  There were a few times, where she suddenly would hold out her
hand and not say anything, so I would panic and think that I forgot
something.  Sheesh!

I talk with my hands, and I'm an outgoing person.  But try to perform
an activity with your elbows glued to your sides.  My shoulders were so
tense.  Finally the uterus and ovaries were removed and the surgery was
complete.  Dr. Grisham then placed a few subcutaneous sutures to help
close the incision.  Then it was my turn.

I'm pretty coordinated with my hands, but trying to place sutures
with everyone watching is not fun.  Everyone was looking at my hands
that could barely hold the needle holders and this shaking needle is
trying to stick into the skin.  It was like trying to sew during an
airplane takeoff.  I had to grasp the skin with the forceps in my left
hand and then attempt to make my stich with the needle in the needle
holder which is being held by my shaking right hand.

BTW, nobody ever ask me to disarm a bomb, okay?

My first sutures were loose and gnarly, and I was trying to keep count
of how many knots.  I was doing a Simple interrupted stitch, which is a
row of individual stitches, each of them have 6 knots in it.  So i'm
trying to count to myself and stay calm and try not to stick the needle
too deep and try to keep my hands from shaking so much and oh yes i
have to remember to breath, etc....

Finally I placed the last suture and we were done.  I was glad to be
over and my neck and shoulders were extremely tight.  But I made it,
and I don't have to do it during lab again.

I felt relieved that I was done, but part of me felt like a complete
idiot.  My brain was spinning from trying to rack up all the things I
had done wrong, but then was also trying to rack up what I had done
right.

And then I had to go study for a quiz.......

I'm glad Dr. Grisham has been so patient with me.  There are times I
know I get on her nerves, and I'm really trying to show her I can be a
great tech.  I think it's because she's a mom and she can be stern, but
she knows that at least I'm trying.

And almost EVERYONE has to go through this.  No one likes to be put on
the spot.  I remember Abby was in tears once because Dr. Grisham had
giving her a hard time when she tried giving an IM(intra-muscular)
injection to a cat.

Whew!!  Next week, I'm Pack Prep, which means my job doesn't start
until everythign is over.  I'm in charge of cleaning up all the
instruments, gettng the gowns washed and folded, etc.  That's pretty
easy, so as long as I have my class notes with me, I should be okay.

Had I been at work, and it was just me and the veterinarian working on
sutures, I probably would have done better.  But there were so many
factors that just kept adding to my nervousness, I was just glad that I
was able to hold it together.  I would be honored to have the chance to
help out in a surgery at work, but I'm not sure I would be ready to
do it in front of all my classmates and professor again.

Out of all the tasks in the lab, this one was by far the hardest.  The
next hardest ones for me will be placing the endotrachael tube, placing
the IV catheter and monitoring the patient during the whole procedure.
I should do okay for those.

ARGH........  I managed to get my homework done, and fortuntately on
Mondays all I have is Diving practice.  I'm still tired, but my throat
isn't as sore, thank goodness.

Time to feed the cats, pack for tomorrow and call it an early
night.....

Kristi