Friday, September 21, 2012

Veterinary Adventures

For a few years now I've been volunteering with an animal rescue and have done different things such as completing home visits and fostering dogs. This summer, though, I began volunteering with a low-cost veterinary clinic associated with the Rescue.

I made it very clear when I began that I didn't know anything, am not a veterinary technician but was there to help where they needed me. Because of my lack of knowledge in this area, I expected that I'd be cleaning up poo, folding laundry, and in general, doing things that couldn't possibly involve canine "patient care."

Much to my surprise, my first job was to play "recovery nurse" to dogs coming out of surgery. And, in fact, that very first day since my charge was still on the table, I was able to come right into the surgery room and observe the neuter taking place.

The second time I went in to volunteer, they taught me how to take the animal's temperature and where to record it, among a few other things.

Each time I've gone in, the veterinarians and the technicians have taught me more, although sometimes planned lessons are interrupted by surgical needs or emergencies. For example, today I was learning about the surgical instruments and how to prep them to be packed and sterilized, but there were some complications with the dog on the OR table, so the vet tech had to run. I also ended up there, but was given another task; a lesson that in fact had been offered previously but was, as usual, interrupted by the work at hand.


Maybe it would be best if I just explained how today went, whilst it's still fresh in my mind.

This morning I arrived around 11 am, greeted the receptionist with "I'm not from the government but I am here to help", walked to the back room and dropped off my backpack containing a few random things, including an extra set of scrubs in case a change would be needed. (Whether human or animal, in any area of  medical care, without warning one can become covered with unmentionable fluids. It's best to be prepared and assume that's going to happen at some point.)

As it was a surgery day, I headed to the surgery room (or OR for short for purposes of this blog) to see who was there and say hello, announcing my presence and ability to do their bidding. Now that I've been there a few times, they remembered my name and a little banter took place.

The lead tech asked if  Vet Tech D. wanted to show me how to put together a [surgical] pack and if I'd like to learn. Sure! So we went into the back room which holds a table, chairs, and the various kennels containing the often quite noisy patients of the day. One puppy in particular was exceptionally adorable with his exceptionally high-pitched cries so I confess I missed most of D's instructions but tried to follow visually, at least.

One of the waiting pups in particular got my heart, however. She had the German Shepherd face and ears and looked like a mix, maybe White GSD? Maybe American Eskimo? In any case, I was drawn to her and confessed to my preceptor for the moment that I was "in love with her.".

He was already chuckling. "You haven't even been here 10 minutes and you're already in love?"

Yup. That's how I roll. You'd never notice that I love dogs.

D. continued with his instructions/demonstration amidst all the noise and love going on, but  was interrupted by the veterinarian (let's call her Dr. V. for "Veterninarian), to please come to the OR. He came back in a little while explaining that the dog in question was having some heart rate problems and apologized. I worked on keeping the kenneled dogs quiet as none of the rooms are sound-proofed and the surgical team needed to be able to hear.

As it was, I ended up in the OR, too, and since the lead VT had to be there to focus on monitoring vitals,  she offered to teach me how to fold surgical drapes for the surg. packs.  Sure! I was a bit clumsy and even after an example, had to go back and fix my work as I'd folded it wrong. The VT was awesome, though, and told me that she'd folded them wrong for MONTHS and the Vet who owned the clinic never said a word about it.

That took some of the pressure off; knowing that what I was doing was part of prepping for surgery, I knew it was important to get it right, but the other side of the coin, revealing that mistakes in this task weren't vital, really helped me to keep focus and not make stupid mistakes that tend to arise from just being nervous.

While folding the surgical drapes, Dr. V. was exclaiming over some unusual things she was seeing in this particular surgery. The dog was bleeding more heavily than most, the fat tissue seemed to "just keep going on" (the dog was a mama and had only recently stopped nursing), and as was observed, the tissue being removed was just "falling apart".  The good doc explained a few things she'd witnessed with similar surgeries, other oddities and because she'd nicked an ovary, she discovered a few other things with this particular dog. In fact, what might have been considered to be a "mistake" to the untrained observer (, actually ended up saving this dog's life. Dr. V. discovered the beginning of an infection that, if the spay wasn't being done that day, might have meant some very serious things for this poor girl down the road.

As a bit of an aside, I'm a little disturbed that I am so willing to respond to the "look at this!" while the surgeon is pulling out innards, but well...maybe we're all a bit weird in some way. Perhaps it's more important that as a clinic volunteer there is interest as opposed to, say....fainting.

But wait! There's more to this convoluted day, and it wasn't just a strange uterus and infected ovaries! 

First, there was a leak in the autoclave (which sterilizes the surg. packs). D. thought it might be a seal that needed to be replaced as he could see steam coming out.

When the first dog had been closed, finally, the lead VT showed me how to clean bloody instruments, and this was a task being given to me. No problem. As it was, though, I never got to them as the 1st dog's recovery was taking far longer than usual. She couldn't be ex-tubated and taken to a kennel for observation yet, so I remained with her so the staff could take a break and eat lunch. Then she had to run to the administrative offices for some other task. I remained with the patient, after Dr. V. came in to make sure I remembered the signs of the dog waking up (blinking eye when stimulated, swallowing), and because I'm still not sure of canine vitals, I made sure from VT. D. that I would know when the Pulse Rate was problematic. I also keep an eye on O2 sats.

As it was, Dr. V. was nearly done with her break but I had to yell for her as the PR (pulse rate) fell to 70 and below and I knew we couldn't wait. She came in to intervene, asked me to take a temp and determined that although we'd been working to warm the dog, had to remove the warmth to help her wake up.  We also needed to be able to continue with other scheduled surgeries.

I was prepping to leave as I had several errands to run, especially in relation to a foster dog coming to me tomorrow evening and prep for work tomorrow morning. I let Dr. V. know my exit time, and that's pretty much when all hell broke loose.

First, VT D. went to refill the Isoflurane, aka "Iso" the anesthetic used during surgery (inhaled). Well, the fluid was leaking and although he was quick to mop it up, much escaped into the air. I'd been with the recovering dog for a time and was actually coming into the OR to say goodbye while someone else went to sit with recovering animals, and ended up assisting with intubating the next patient.

That's when the leak happened, when they realized he wasn't "down" enough and had to use the "Iso" first. The spilled happened, they recognized, suddenly, that the O2 was almost empty and went to find a new tank...and there wasn't one. So while we waited in a room filed with airborne evaporating anesthetic,  Dr. V. had to leave to get an Advil for a sudden crushing headache.

I waited with the pup, holding him to keep him calm, and after awhile Dr. V. told me to vacate the OR with him as they'd realized the spill was worse than they'd thought. I went to the back room while fans were set up to vent the entire clinic, and in the meantime, managed to pop off the cap to the pup's catheter. Immediately, while watching it roll away, I found one of the staff to re-cap it. It was odd that it wasn't just gushing blood but it was decided to cap and wrap it until it could be handled. For the moment, all surgeries were in a holding pattern.

That's also when we realized two emergencies were coming in, one with a very sad, sad story. Although I'd planned to leave, I agreed to stay, but have to say the staff was hesitant to ask me to do so, as a volunteer.  I assured them that I could stay, no one depending on me, and remained to assist in peripheral ways with the incoming emergencies.

As it turned out, maybe it was a good thing that I remained. While I didn't get a headache, I did go through a very "sleepy" stage and had a bit of a medicinal taste in my mouth. It probably was the effect of the spilled Iso, which I'd inhaled freely in the OR until directed to leave with the puppy.

 While the staff  focused on what they needed to do, I remained with the recovering animals, ran an errand for the clinic for what was incoming (don't worry, was fine to drive), and finally, when all settled down, asked if it was OK to leave while giving the status of an animal of concern.


I learned a lot today, in spite of the fact that perhaps I didn't learn what was in the informal-on-the-spot lesson plan. I didn't actually clean the surgical instruments, and I didn't actually learn how to pack the ones that were clean. But I got to assist a dog in recovery, re-attach oxygen to an intubated dog, monitor vitals and in short...did a whole bunch of things I never thought I'd do.

And you know what? It's all completely un-glamorous life-and-death serious but I LOVED it and can't wait to go back, maybe next week. While I get my puppy-cuddle therapy, I also know that there is value to the work, that we are helping animals AND their people, and I can't wait to learn even more so that I can do more to assist the Veterinarians and Techs in their work.

Now please excuse me while I go over and hug my Tikaani, who spent a good 5 minutes sniffing me in my scrubs when I came home this evening. She's feeling a bit neglected and it benefits neither of us to spend my time with other people's pets if I'm ignoring my own!

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