One down...

We survived the first day!!!  Our day started at 7:30am and ended at 5:30pm.  It was 10 slam-packed full hours of doing, minus the 15 minute break to sit for lunch.  I knew we were in for a fast learning curve when, upon our arrival, 2 families were already waiting at the clinic door this morning.

The first half of the day was peppered with walk-in appointments while the last half was full of surgeries and straggler walk-ins.  There were dogs with open wounds, a cat with a questionable alopecic area which looked like a burn, a kitten with a possible wrist (carpometacarpal) luxation, and several vaccinations.  One lady was impressed we took the time to ask about and examine her dogs when she brought them in for booster shots.  Apparently to her a vaccination appointment is usually a wham-bam-thank-you-ma'am ordeal with very little conversation or eye contact.  To me, routine appointments provide a great opportunity to connect with the owner and discover some of the intricacies of their daily animal care.  I was happy to know she was appreciative of the dialogue!

Today's surgery list included: 2 dog spays, 3 dog neuters, 2 horse castrations, and 2 extensive wound cleanings.  I was supposed to be in charge of performing/overseeing the spays, neuters, and wound cleanings.  In reality, I had time for the spays.  Only.  (I'm extremely thankful for the awesome support of the other mission team-members who gladly shouldered the responsibilities!)

In my defense, both spay patients were in heat.  This means their uterine and vascular tissues were all engorged, very bloody, and highly friable (aka, the tissue would rather morph into a bloody mess than be handled at all).  The first one went off without a hitch, though it took me a few tries to find the bifurcating tube of tissue the size of Texas.  I double ligated both pedicles (the blood supply to the ovaries) and the uterus and cleaned up.  It was over in less than an hour.  The second one, however, was a learning experience.  I was in the teacher role rather than the surgeon role and the student performing the surgery was doing a terrific job!  He was able to get better tissue exposure and ligature placement than me!  We noticed a small pooling in the abdomen as he was going to close but I assured him that some seepage is normal.  He still seemed nervous though, and to appease him I decided to dig around for any evidence of a faulty ligation.  I couldn't find anything horribly offensive but threw a transfixing ligation through the left pedicle just in case.  We drove on.  He stepped out in faith that I was leading him in the right direction.  It was when he was closing the body wall and seepage was still present that I decided my level of comfort was being imposed upon.  We opened the abdomen again and still couldn't find an obvious bleeder.  After much rigamarro and tenacity we stopped the seepage though!  It seems that we were dealing with a very obstinate pedicle. It took a grand total of 2 1/2 hours.  The dog recovered well and even awarded us with a tail wag when I went back to check on her this evening.  This little patient taught me a lesson in staying calm under fire and being extra cautious when another person's self-assurance might be compromised due to my instruction.

Here's a snapshot of live action in the surgery suite:

Left-to-right: Stephen, Becky, me, Melissa, Dr. Crouch.  Photo taken by Lauren.

And here's my clinic for the next 5 weeks!:



You can think of it as an old condemned building or an old very loved building.  My opinion is still undecided.

I'm looking forward to tomorrow and hoping the experiences from today lead to even smoother sailing.  It's time for brain re-charge now though.  Here's to the first day down!