This was by far the most relaxed rotation, with only two and a half contact days during the week. Although it was nice to have a bit more spare time than usual, I found it concerning how little time is allocated to the two most common areas of general practice.
On Monday we had a three hour dentistry prac where we practiced nerve blocks and dental extractions on dog cadavers. It was gory, but a really valuable learning exercise. That was it - three hours to become competent dentists!
Wednesday and Thursday were spent in the dermatology clinic, working through real clinical cases, assisting with procedures and practicing diagnostics. The veterinary dermatologist has a bit of a reputation for embarrassing students, which was confirmed within the first half hour when she asked me for the dose rate of Prednisolone in front of the clients. “Errrrr… I don’t remember” was the best I could come up with. She justified the attack by saying I’ll never forget it now, and she’s probably right. For any vet students reading, it’s 0.5-1 mg/kg - stash that one away!
I found dermatology surprisingly interesting, but it was evident that being a veterinary dermatologist would become repetitive pretty quickly. Of the three dog consultations I was involved in, all three had suspected allergies. After hearing the vet’s food trial spiel three times, I feel pretty confident managing an allergy case myself.
On each of our patients, we practiced performing diagnostics such as otoscopic exams, sticky tape preps, superficial and deep skin scrapes, and ear cytology. I witnessed a couple of intradermal allergy tests, which I found really interesting having been through the same process myself for my cat allergy. I also saw an ear flush on a dog, and a skin biopsy procedure on a cat with severe dermatophytosis (ringworm) that had caused deep ulcerative lesions all over the body.
On Thursday afternoon, a couple of the medicine interns taught us how to do skin biopsies on pig trotters. Unfortunately, someone had taken the trotters out of the freezer prematurely and they were well into the decomposition process. The smell had us all retching and gagging, so we worked quickly and finished in record time. I don’t think I’ll be eating pork for a few weeks!
Seriously! Lol Tomorrow morning is my lumbar nerve block. Hoping it works so I can have an ablation to avoid surgery for a bit. I know I’ll need surgery at some point, but I kinda would like a year off being under the knife before having to bite the bullet. #nerveblock #lumbar #ablation https://www.instagram.com/the.chronic.pain.mask/p/CZNV6b-Pk0q/?utm_medium=tumblr
What I'll look like for the next 24 hours. I had a nerve block today. Dr. Killroy injected litocane and steroids into the trigger points on my shoulders and neck and into the nerves on the back of my head and above my eyes. It was intense to say the least, but the doc told me she's done this hundreds of times over the years and she's never seen anyone keep their cool doing it like I did. She said I'm super strong. So, that made me feel good. The migraine is 60% better and the nerve block should last 10-12 weeks. Already have nerve blocks set up every 3 months and I'm starting Botox treatment in January every 3 months to manage my migraines. Here's to 2022 being filled with a lot less pain! #migraine #nerveblock #health #ice #heat #relax #headacheclinic #Neurology https://www.instagram.com/sashalessa/p/CXU30J-tajd/?utm_medium=tumblr
Acute Heart Failure Treatment Paradigm Challenged by Splanchnic Nerve-Block Studies
Acute Heart Failure Treatment Paradigm Challenged by Splanchnic Nerve-Block Studies
VIENNA — Volume overload often may not be the primary cause of congestion and symptoms in patients hospitalized with decompensated heart failure (HF). Sometimes, rather, decompensation may be triggered by redistribution of a stable fluid volume from the intra-abdominal compartment to the heart and lungs.
That process, mediated by the sympathetic nervous system, may be amenable to interventions…
