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| Some friends who we know we are always going to be friends
When I ask myself a question: what did I do before I know who I am. I cant really give an answer. I couldnt use any words to probably define myself. I have no identity given. I was a very typical naive teenager who didnt know what life is and what it is all about. I feel like I have missed out a very important stage in my high school life due to my lack of consciousness around me. And if I am given a second chance, I know there are many things that I would have done to try to make my life perfect.
But now looking at a photo, I have realized my smile with my high school friends was very genuine and solid. From the smiles, I can recall all the golden memory that has fallen apart at the back of my mind. All the fragments seem to come together nicely to give me the picture, the motion, the sounds and the vivid colors. The time when we went to play basketball in KLN City, the time when we went to KFC and eat like a refugee, the time when we ran around the school after classes and act like a child and we also formed a study group (for just a few days) to prepare for the CE. At the end of the day, I reckon my high school life wasnt bad at all, because we have such a pure friendship and we know that, deep in our heart, we will gather together again and say cheers to those memory.
And now If I am given a second chance to walk through my life again, I dont need any changes for the 5 Amigos are never going to change.
We have become a young adult and our true life long journey has just started. There are increasing expectations from the society. At times of exhaustion, a photo like that would just remind us how much we have grown and learnt to become more of a full human.
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| I have never thought an exam could be that stressful. Having 9 papers in 3 weeks was a challenge to my capability, my concentration, my determination, my physical and spiritual strength. I am not complaining how suffering it is for me to go through the exam period because there are many other people in the world living at the survival edge and struggling with life threatening conditions. But I just want to say, when I am sitting here at my room reflecting how I coped with the overwhelmingly stressful exams, I am really glad that I have made this far and I did learnt something other than the knowledge from this exam.
The most important thing that I have learnt is probably to acknowledge that I am not alone. I am always not, alone. In the study mode with all my adrenaline pumping through my body from 8am to 12pm, I have a strong tendency to live in my own world and selectively ignore all the things happening around me. The degree of concentration that I have on the scientific names, medical terms and disease processes has created a barrier separating me from my Saviour, friends and family. I worked very harsh on myself and didnt give a thought on things other than doing well in the papers. When I thought I would be relieved after finishing the last paper, I feel so devastated because I lost my direction completely and chose to withdraw myself from the crowd. A very deep depression that I have never experienced before came to me. I was very much burnt out. I was forced to cope with waves of challenges that stretched my tolerance limit.
Now thinking backwards, sitting on my cozy chair, I am just really amazed. I will never forget the moment when I walked into the exam hall with my messy hair, barely opened eyes, blocked nose, clumsy clothes to keep warm and a banana and apple in my bag. Classic.
Time to say goodbye to Anatomy and physiology. Will happily meet Pharmacolgy, Pathology, Parasitology and Animal Health and Management again. Big welcome to Bacteriology and Clinical Science in the next semester. =)
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| I think 2 part-time jobs during school period will be too much of a commitment, so I finally decided to call my boss of Crystal Palace, which I have been working with for nearly one and half a year. I told him I will only work with the team during holidays. I am so glad that I actually made the decision because working 16 hours on Saturday is just totally exhausting and making me less focused on Mon and Tues classes. So from now on, I will stick with my position at the Lost Dogs Home and be a caring vet nurse every sat morning.
Today's work was a bit rushing because there was a flood of nice people came in and adopted animals. On average, there are 10 adoptions from 9pm to 1am. With the paper work and nurse consult that me and my partner have to do, we are quite occupied (but do have sometime to take sips of coffee =P ). But then today there were 17 adoptions so we had to gather people outdoors, make them to listen up and give a small talk. Sometimes it is just very frustrating to keep them focused in this situation because they may come as a family of 3, so if I do 4 adoptions at a time, there will be 12 people plus 4 dogs. There are kids running around and randomly interrupt me by asking funny questions like 'what is the number of Lost Dogs Home?' or 'was my dog a cat before?'. Ok the kids are fine because they are just being kids. But the dogs might get a bit excited to interact with new people and busy sniffing, licking and barking at their doggie friends When kids and dogs blend together... it is hard to get them under control. The most remarkable experience was: there was this mother who brought 6 of her children ranging from 2 to 20 years old. They kept making noise by squeezing toys and stamping on the floor... and the 2 youngest boys fought with each other due to some issue with choosing the right color for the dog's collar (thats fine cos they care about it). At the other end, another kid played and rolled on the floor with the dog (still fine because they get along well). The dog was just too hyper and wagged her tail and hit on a kid's face. The kid got upset because he thought the dog didnt like him anymore and the elder sister had to comfort him and so on. But anyway, they were all good experience as I will be gradually trained up to be more comfortable and confident to speak up in front of clients, even though the situation seems a bit out of control.
Today there was an interesting case about a cocker spaniel. This dog has a tumor around the anus, thus perianal hyperplasia. This overgrown mass is thought to be benign and it shouldnt impose a health issue on the dog. But the vet was worried that the tumor will progress into a malignant one because the cells there can be easily infected by bacteria or viruses. So the vet has taken a piece of tissue and sent it off to pathologists, so the cells' status can be identified under a mircoscope and a diagnosis can be made.
Sometimes, there are things that a vet working in a clinic will not have to do, one of these will be pathology. This points out the fact that people holding a Veterinary Science degree can have a diverse choices of career path. Some of them specialize into a veterinary pathologists sitting in a lab and examining slides and diseased organs, some of them specialize into veterinary radiologists pointing out where fractures are, some of them specialize into pharmacology working in a pharmaceutical company, some of them work as a farming enterprise consultant giving management advise to farmers and make sure they can make profits, some of them are more concerned with populations health including human, rather than individual animals, so they work in the public sector, monitoring meat hygiene for human consumption or preventing and controlling disease outbreak that may jeopardize humans health.
I hope the career path that I take in the future is meaningful and rewarding, which keeps me motivated to spend my whole life with.
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Here it comes the timetable for this semester. I really have to work hard on my study.
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| This is my 3rd week to work in Lost Dogs Home as a veterinary nurse and I think I still need some more time to catch up with the pace of the working environment and to obtain a bigger picture of the operation flow.
The front reception of the clinic
I have been exposed to different fragments of procedures such as premedication (drug treatment given to a patient before surgery), induction of anesthesia: I have to hold the patient's forelimb and restrain it, allowing the vet to locate the cephalic vein and inject intravenous anesthetic drug such as Thiopental. The patient will then lost its consciousness within a few seconds and its the time to insert (intubation) an endotracheal tube, a tube with one end attaching the anesthetic machine which supplies pure oxygen and maintenance anesthetic drug such as isoflurane; the other end is inserted down to the thoracic inlet, with an inflatable cuff being able to be filled with air, thus expanding the trachea to prevent collapse and seal the trachea to avoid leakage of oxygen and isoflurane. Intubation can be facilitated through topical anesthesia by applying 1-2 drops of lidocaine on the arytenoid cartilage, thus relaxing the muscles that control the diameter of the larynx.
A range of endotracheal(ET) tubes in different sizes
The animal will then moved from the preparation table to the surgery room. Once the ET tube is connected with the anesthetic machine and the pulse oximetry (a device that shows heart rate and blood oxygen saturation level), the vet will go through all the sterilizing steps to ensure the hands are germ free. At the same time, I will prepare the surgical site by rubbing it with cotton balls soaked in chlorohexidine (a chemical antiseptic that kills both gram-positive and negative bacteria) and get the surgical kits and surgical drape ready. The kits have all the surgical instruments that are only suitable for that particular surgery. The drape is to protect the surgical site by minimizing any foreign materials from 'landing on' the incision site. They are all packed prior to surgeries and sterilized via autoclaving in a very strict manner. At a time, I made a mistake and contaminated the opened kit by slightly touching it for less than 0.5 sec and the whole kit cannot be used and has to be wrapped and sterilized again. I think its not just a science, but also an art to maintain every single step to the hospital grade.
Autoclaving machine
The vet will then notify me that he is ready to cut open the animal. This is a critical time to monitor the heart rate, respiratory rate and the animals neurological response. If the anesthesia is too light, as indicated by eye blink reflex and strong resistance to try to open the jaw, anesthetic drug dosage has to be accordingly adjusted until the animal is properly anesthetized (from 2% to 3% of isoflurane), otherwise there will be a chance for the animal to jump off the table in response to pain. During the course of the surgery, I got to make sure all the above parameters are in the normal range with respiratory rate no less than 6 per min and heart rate being in a range of 120 to 250, depending on the dog's size and growth stage. Generally, a puppy and a small dog will have a higher HR and an active dog will have a lower HR. However, this reference range is only for dog. For different species, the parameters vary dramatically.
2 surgical tables in the surgery room
Anesthetic machine, pulse oximetry and oxygen tank
Surgical drape covering the surgical site, with the uterus being pulled out
There was a discussion among the vets in the surgery room while they were doing desexing operation. I was presented with 2 surgical approaches: the abdominal mid line and flank. For the abdominal mid line approach, an incision of 1-2 cm is made along the abdominal mid line 3-4 cm caudal to the umbilicus of a kitten. While the flank approach has an incision site 2-3 cm ventral to the 5th-6th lumbar vertebra laterally of a kitten. The advantage of the later approach is for its hygienic reason as dirt from the ground makes less contact with the incision site; while the former one is solely for its cosmetic reason.
to be continued...
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