I've been preoccupied!! (aka, the Olympics were on...)

I said I was going to make an effort to write more frequently, didn't I? Well it's been a month since my last post. Oops. In my defense, I've served as a dedicated living room cheerleader to all...ok, most...of our American Olympians. I could list who and what I'm proud of, but that's just obnoxious and not what this blog's about, so I'll simply say, USA! USA! I've also been traveling around northern Colorado and Wyoming where internet connectivity is a bit sketchy.

 

My travels since July 16th have included driving from Window Rock, AZ down to Tucson, AZ, over to Las Cruces, NM and Ozona, TX, then on to Austin and Dallas, up to Colorado Springs, CO, Fort Collins, CO, and on to northern Wyoming. I'm back in Colorado Springs for the weekend now.

 

I've gotten far enough behind in my blogging that the last months on-goings will have to be posted in segments. Sorry. Here's the first installation:

 

 

The previous blog was written the night before the Rocky Mountain Spotted Fever (RMSF) summit meeting with several of the Navajo nation's leading health representatives. I thought I would be co-presenting with Dr. Bender out of Chinle, but when the time came to speak, he and his Indiana Jones-style fedora were nowhere to be seen. So there I stood, backed by a floor-to-ceiling projection of a PowerPoint presentation designed by the CDC, with a microphone and laser pointer for company. I was nervous at first. I said "OK" too much. Mid-way through I felt more comfortable and was able to answer most of the audience's questions. If I didn't know the answer, I simply referred to the table on my left which was surrounded by CDC representatives. By the end of the presentation I was feeling pretty good! Even when Dr. Bender magically appeared to my right and started eagerly fielding the audience's questions, I maintained my ground and answered right along with him. Overall, I think it went really well. I'm thankful I had the opportunity to participate in community education/awareness and also hear about other professionals' knowledge of and efforts against RMSF.

The clinic staff and I went out for dinner that evening and then my time in Navajo was over. It was an absolutely unforgettable experience. The people who I had the pleasure of meeting and working with blessed me beyond belief and I look forward to seeing them again in the future.

Left-to-right: Anderson, Landon, and Carmelita "Carm" Lee, Naomi, Patrina "Sowa" Begay, me, Adrian "Age" Catron, Meranda Laughter, Glenda Davis, Mia, and Kendra.

Randomly ran into Miss Navajo Nation 2011-2012, Crystalyne Curley, at the bank one day!



Standard Tucson saguaro photo!

I spent the next day driving down to Tuscon where I stayed overnight with long-time family friends, Terri & Mike Sullivan. Terri, Mike, and their 2 dogs, JoJo & Loretta, toured Cheyenne and me around their Saguaro-covered city in their RV camper that evening. No, they don't live in the RV. Yes, our fuel-efficient cars were available. But they decided many years ago that their RV would no longer be a driveway ornament, and if they had it, they would use it. I thought it was brilliant! Terri and I sang The Beatles "Get Back" over Blue Moon's while Mike shuttled us to and from the dog park. Cheyenne sat up front with Mike to act as co-pilot if needed while JoJo & Loretta curled up under the table where Terri and I were sitting. We spent the rest of the evening eating delicious pizza, playing guitars, and talking about pets. Very relaxing.

Me, Mike, and Terri

I met Judy (the friend who I stayed with on my way to Window Rock) in Las Cruces for a late lunch the next day. I gave her the highlights from my month and she again shared stories from her time as a foreign services employee. I love Judy's stories. They are always full of color and life and beautifully depict her life before retirement. Her stories feed my soul's foundational desires to travel, find community on a global scale, and share the intrigue of other cultures with everyone I know. If only I could possess her sharp memory and gift of storytelling!

I crossed into Texas after lunch, and as soon as I was east of El Paso I was surrounded by rainbows. Seven rainbows. In West Texas. Where it never rains. I could only think it was God's way of telling me I was back in a promised land. I'm not saying Texas is the only promised land or that it's better than anywhere else, I just felt like I was back in the state where I'm meant to be and God was simply highlighting that fact.

 

 

The day ended when I pulled up to my dad's cousins' house in Ozona ten hours later.

 

To be continued...

Two trips, a holiday, and a birthday

Wow guys, it's been awhile since I posted last, sorry about that!  Since the last post I've gone to Santa Fe, celebrated July 4th with a rainstorm, gone to Lake Powell, turned 25, and finished out my last solid week of work here in Window Rock.  It's crazy, I can't believe I've been here for a month!

So on June 30th Cheyenne and I packed up and made the 3 1/2 hour drive to meet my mom and 3 of her friends in Santa Fe, NM for the weekend.  It was a nice relaxing weekend full of window shopping, flea market shopping, and eating at delicious restaurants.  Thanks for the girls weekend Mom, it was a blast!  That weekend also brought the birth of our family friends, Mark & Linda Riederer's, first Dexter calf.  This particular long-legged calf required much coaching before nursing appropriately, much to Mark's dismay.  I think some gray hairs may have sprouted on Mark's head as a result of this calf's discombobulated sense of anatomy.  No worries though, the calf finally stooped low enough in the end!  On our way back to Window Rock, Cheyenne and I stopped in Albuquerque to run a few errands.  Sine these errands proved to be rather exhausting, it was a beautiful day, and we had no agenda, we stopped to play a game of fetch and take a nap under a tree.  It sounds whimsical and silly when I write about it, but in actuality it was really really nice and relaxing.  If you get a chance to take a nap under a tree someday I hope you take it!  The view:

Nap time under a tree.  Highly recommended! ;)

The next week consisted of 2 work days and 3 off days, plus the weekend.  Gotta love flip-flopped weeks!  On Monday (7/2/12) evening Cheyenne and I went to the Window Rock monument to enjoy the sunset, which, of course, was beautiful...

On Tuesday, BaaBaa, the 9-day-old, broken-legged lamb came in to the clinic.  After radiographs it was evident that her right front leg was certainly broken--directly through the metacarpal growth plate.  Perfect.  Time to phone-a-friend! This time it was Drs. Dominguez and Roussel.  With their blessings I put a cast on this lamb and told her owner that she must return first thing Monday morning to have the cast removed.  I was nervous because we typically don't like to leave fully-circumferential casts on for more than 2-3 days, especially in young animals.  This one would be on for 6 days because we were closed for the holiday.  On Monday, the 9th, they came back for cast removal and the leg looked great!  It was straight with no evidence of casting complications (infection, thrush, compression sores, etc.)!  I think I did a happy dance and thanked God for keeping the leg healthy.

Aside from laundry, clearing out my inbox, and going to the movies with a couple friends, I did a whole bunch of nothing on Wednesday, the 4th, and Thursday, the 5th.  The vet clinic here in Window Rock is located ON the fairgrounds and, since it was the week for 4th of July, the carnival had descended upon the fairgrounds.  Needless to say, the vet clinic was exceptionally difficult to get to.  On the 4th, I snuck onto the fairground premises, avoiding parking fees, and locked myself in the clinic to take advantage of free wifi and wait for the fireworks show.  The fireworks were scheduled to go off right behind the clinic after the rodeo finished up.  I was gonna have front row seats.  For free.  Yes!  Little did I know that Mother Nature had different plans.  The rain started as a drizzle in the middle of the rodeo, then the wind picked up.  By the time fireworks were scheduled to begin everything was so wet that lighting a fuse would require a blowtorch.  And maybe a bucket of lighter fluid.  So...I had my first July 4th with no fireworks show.  Womp womp.  I'm looking forward to the fireworks at New Year's!! (Irony note: my iheartradio is playing Katy Perry's "Firework" as I type this.)

On Friday, the 6th, Cheyenne and I drove out to Page, AZ to meet up with my friend, Devin, for a weekend on the lake.  Lake Powell is marvelous.  It makes no sense to me.  It's warm, gorgeous, blue water and soft beaches are surrounded by sandstone cliffs out in the middle of the desert.  We spent the weekend camping, napping on the beach, getting tan (or horribly sunburned), and driving to picturesque places.  We also went to the grocery store in town at least once daily for items we forgot to bring/buy.  (That little tid-bit is for you, Lauren Quast, lol).  Devin and Cheyenne played fetch for hours on end, we went down to the beach at night and debated on the location of the Little Dipper, and we made friends with one of the park rangers, Leonard, who told us his life story.  It was perfectly relaxing.

Lake Powell, Glen Canyon Dam is to the right of the frame

Horseshoe Bend.  A 15-minute drive + 10 minute hike from our campsite.

Can you see those 3 tiny specs down on the sandbar? Those are fly fisherman.  Just for perspective.

Devin at Horseshoe Bend

Cheyenne couldn't contain herself

Next time I go to Lake Powell I'm hoping a house boat will be involved.  Exploring the slot canyons by boat is supposedly the way to go!

The last week at work proved to be just as interesting as the previous weeks.  Monday brought in my first equine lameness case (bowed tendon of the right front).  I didn't handle it well.  It didn't help that cell phone service was a complete tease that day and thwarted my attempts to call for guidance.  After a couple hours, a few treatment plans, and several apologies, the horse and her owner loaded up and headed home with bute (an anti-inflammatory pain killer), salve for a sweat wrap (nitrofurazone + DMSO), and at-home care instructions (hydrotherapy and stall rest).  I was afraid the owner would be annoyed by my inexperience and insecurity, but after I apologized and admitted that I had spent a lot of time trying to think of what someone else would do, his facial expression softened.  He said "It's okay.  But I came here for your opinion, not someone else's."  Noted.  I'll try to remember that next time.

Tuesday was a special day.  Everything was perfect that day!  The two scheduled cat spays went well and all the walk-ins were manageable.  When I was in the middle of my first surgery of the day (pregnant cat spay), Carm, the head technician and my leading cheerleader out here, asked me if I had plans for lunch.  Nope.  She approved and informed me that lunch reservations had been made at the Mexican restaurant in town.  The office was taking me to lunch for my birthday.  I couldn't stop smiling under my surgical mask :)  My silly grin and welling sense of appreciation for these people grew even more when I realized lunch was not the only thing they were giving me.  I walked in, sat down at the table, and was presented with several unforgettable gifts.  Carm and Sowa gave me a beautiful shoulder bag and silver/turquoise earrings, Meranda gave me yellow shell earrings, Mia gave me silver/turquoise earrings and a necklace, Glenda gave me a cosmetic bag (which coincidentally matches the shoulder bag), and Ashley's uncle made 2 cheesecakes.  Then the whole restaurant sang "Happy Birthday" to me as a flashy sombrero was plopped on my head.  When we got back to the clinic, Carm brought her little brother into the office so he could sing a Navajo birthday song to me.  It was so neat!  Not to mention all the phone calls, text messages, and facebook messages from all of you.  Thank y'all so much, I felt really special for my 25th :)

One of my birthday afternoon walk-ins was Olive, the pregnant Chihuahua who had been in labor for over 15 hours and only produced one puppy.  We took an abdominal radiograph and, sure enough, one puppy was left behind.  When puppies (or kittens, or foals, or...) come out of the birth canal they should look like Superman--front feet forward, head forward, and cape blowing in the wind.  This puppy wanted to be different.  She was trying to come out sideways.  Rib cage first.  Not gonna work.  I informed the owners of this puppy's plight and said that spaying Olive was the best option, and unfortunately, since she had been in labor for so long, this puppy was probably a goner.  They were okay with that, they just wanted Olive to be happy and healthy.  The surgery was considered an emergency and ran after hours.  Just so you know, after hours work is NOT usually done at this clinic.  I, however, was simply thinking about getting this puppy out and gave no consideration to the timing.  Sowa decided she could stay if I could give her a ride home (30 minutes away).  I was happy to have help and gladly agreed.  Olive's surgery went perfectly!  A lot of people don't like doing surgery on pregnant dogs/cats, but I'm finding I actually enjoy it!  Its a lot easier to see important structures.  I handed the puppy-filled uterus off to Sowa, encouraged her to extrude the puppy as a learning experience, and went back to work on Olive's closure.  Then I heard Sowa pipe up.  She said "Uhh, Doc?  I feel a heartbeat on this puppy." What??? Unbelievable!  Well, wish I had taken that possibility into consideration when I came up with the sedation/anesthesia protocol.  Great.  This puppy was gonna be sleeping for awhile if she survived.  I told Sowa to gather a suction bulb, Dopram, and a few huck towels, and delegated neonate-care instructions to her from the surgical suite.  She did awesome!  The puppy never breathed for her but the heartbeat remained consistent.  By the time I finished with Olive, Sowa expressed that she was tired of working on the breathless puppy.  I grabbed a tuberculin syringe to clear the puppy's airway since, apparently, there is no suction bulb in this facility, slung it a few more times, and rubbed it vigorously before it started squealing in repugnance.  After another hour of prodding and encouragement, the puppy perked up enough that I felt comfortable leaving her with her mother and brother.

Happy birthday baby girl!  You were born on a good day ;)

The next morning the owners came for Olive and her original pup.  Their faces were priceless when I told them they were gonna have to make room for another puppy...I may as well have told them the Beatles were coming to Window Rock!  The grandmother expressed abounding gratitude for the level of care provided to Olive and her puppies and for my willingness to perform the surgery after hours.  I wanted to spend all day with this family, they were absolutely lovely.

The rest of the week went rather smoothly too.  I'm really going to miss this place.  Not enough to accept any of the job offers I've received though.  Glenda asked if I'd be interested in a job here at the Window Rock clinic, and then Dr. Jensen, a veterinarian in Gallup, whom I called for a second opinion on a big dog-little dog fight case, asked if I would be interested in taking over his whole practice.  Sight unseen.  Craziness.  I've never known what it's like to be a commodity before!

This weekend was spent avoiding packing, avoiding writing this blog, and hanging around Window Rock.  Tomorrow is my last day working at the clinic.  I have mixed emotions about this.  I don't want to leave these people, I want to take them everywhere with me!!  On Tuesday, I'll be one of two veterinarians speaking at the Rocky Mountain Spotted Fever summit meeting.  Doesn't sound like much, but the CDC (yeah, Center for Disease Control) is coming here to back us up while we present to the tribal counsel the need for pointed efforts against Rocky Mountain Spotted Fever.  Public speaking...my favorite.  Wish me luck!

I'll try to blog in the next couple days.  Maybe some of y'all should hold me to that...

A Week of Firsts

This past week was a whirlwind! It seemed like an endless journey at the time, but now looking back on it, trying to recall the details, it all seems like a blur. I remember events from Monday and Friday...Tuesday, Wednesday, and Thursday, however, all smudge together into "mid-week". I think I'll call it: Tuenesursday.

On Monday morning I walked into the clinic, bright-eyed and bushy-tailed, ready for the week to come. I was surprised at how smoothly the morning seemed to be going, it was refreshing! I soon realized it was because we had no surgeries scheduled for that day. The rest of the day, and week, really, was characterized by a hodgepodge of walk-ins.

Monday brought in my very first ovid patient, a Columbia-cross ewe named Mary. It was clear from the blue nylon collar, the clangy cowbell, and the attendance of the entire family at the appointment that she was a beloved family pet. All I could think was: don't mess this up, don't mess this up, don't mess this up. She had been losing weight and lagging behind the rest of the herd for the past 2 months, not to mention the development of a horribly distended abdomen over the past 3 weeks. The owners mentioned that she lambed 3-4 months ago but they never actually saw the lamb. It must've been eaten by a coyote. They had no idea what was going on with Mary, and frankly, neither did I.  All I knew was that her udder was indistinguishable from her rotund abdomen, she was a body condition score 3/9, and she was otherwise clinically normal.  Great.  I did a physical exam, decided to determine whether or not her cervix was open, and performed a trans-abdominal and rectal ultrasound exam.  That gave me enough information to excuse myself from the appointment and frantically call for guidance.  My phone-a-friends for the hour were Dr. Roussel and Dr. Parsons—two veterinarians who gladly lent their expertise.  With their help I was able to conclude that this was likely a case of a mummified fetus.  You see, sometimes, when birthing goes wrong and babies aren’t actually produced, it’s possible, especially for ruminants,  for the fetus to stay inside the uterus for an undisclosed amount of time and turn into a dried-up, prune-like, mummy.  If the mother stays systemically normal, the prune is called a “mummified fetus”, if it makes her sick, it’s called a “macerated fetus”.  Mary was lucky.  I gave her one injection to help pass the fetus (Lutalyse) and another to ward off infection (LA200), instructed the owners to provide her with plenty of food and water, set up a re-check appointment for 2 weeks later, and sent them on their way!  I’ll let you know how everything turns out once they come back for their re-check.

Juno, the middle-age, hit-by-car dog who I referred to in my last post, was another patient from Monday.  She had been struck over the weekend and had to travel 70 miles with her owners to the Window Rock vet clinic.  After radiographs and an exam were performed, it was obvious that she had a significantly fractured pelvis and a nasty flesh wound on the back (caudal) part of her right leg.  Unfortunate, albeit manageable.  I assured the owners that this was fixable but it would take patience and keeping Juno confined for a couple of months so her pelvis could heal.  The owners toiled with their decision--their whole family was saying to just euthanize Juno and I was telling them it was fixable with time.  Ultimately, they left Juno at the clinic for wound treatment through the week (and it's healed marvelously!) and decided to build her a confined area at home where she could heal over the next couple months.  I was so touched by the committment they had for this sweet dog, it seems to be a rarity on the reservation due to money, time, and anti-fencing constraints.  I was also tickled pink over the improvement of her wound over the week!!  If you're squeamish, look away now.  I'm so proud, I have to share this.  It's my first time to realize that my intervention directly benefitted a patient!:

Juno with the "cone of shame"

Before: Day 1

After: Day 5

In the Tuenesursday of mid-week I witnessed my first desert thunderstorm.  It was breathtakingly beautiful and an experience I hope never to forget.  The energy, colors, and sounds produced by the clouds were an awe-inspiring display of God's love for the desert and it's people.

The latter part of Tuenesursday brought in my first colic patient.  Colic's are relatively routine in large animal practice.  Some vets love 'em, some vets hate 'em.  I've always just been terrified by the idea of them.  This particular gelding had been missing for two weeks (he didn't come back when the owners turned him out into an unfenced area to graze) and was found Thursday morning at a neighbor's house.  This poor horse had dropped from a reportably healthy weight down to a body condition score 2/9.  His name was Tii, which is Navajo for "horse", and he was definitely in bad shape.  His heart rate was 88 beats per minute (normal for a horse is 30-40) and he only had gut sounds in 1 quadrant--definitely colicking.  For those of you who don't know, there are two major flaws in horse anatomy and these two things are what provide job security to equine veterinarians: their feet and their guts.  When one of those goes bad you're in for a sizable investment.  After much ado trying to pass the nasogastric tube (one of the 4H guys had to finally come help me...little did I know that this fully grown horse would require a foal-sized tube) it was determined that a small intestinal obstruction was not the reason for Tii's ailment.  Time to, again, phone-a-friend.  This time it was Dr. Crouch who brought calmness and patience to my frantic mindset.  Together we decided that Tii's colic was due to intense starvation...his GI tract had simply shut-down.  We placed an IV catheter, started him on a fluid bolus, and sent the owners out to get feed and bedding for his hospital stay.  I noticed later, as we were offering food and water, that he kept nosing the water bucket and turning away from the food.  My initial thought was "Well that's weird.  I would have my face submerged in both buckets at the same time if I were as starved as he looks."  I carried on with the fluid therapy with later thoughts like "Maybe he's just so happy to have water that he's playing in it" and "Maybe he doesn't want me to hand-feed him, maybe he wants to eat at his own pace."  Silly me.  When will I start to listen to my first gut instincts??  I told Glenda, one of the brilliant minds at the clinic, about Tii and his strange behavior and she asked the obvious question "can he actually prehend the food?".  Ha!  Can he actually prehend the food? What a silly thing to ask!  The owners said he drank 10 gallons of water before coming in, of course he has prehensile abilities!  Then she walked over to Tii and pulled out his tongue.  And there it sat. Just sticking out of the side of his mouth like a giant piece of pink taffy.  This, my friends, is a tell-tale sign for neurological impairment of the tongue and muscles required for swallowing.  Glenda, you are brilliant!  She mentioned that Russian knapweed, a toxic plant which causes these symptoms, grows rampantly in the area.  After doing some research I found that the plant is tastiest in June, especially to horses, and it leads to liquifactive necrosis of the nerves associated with food prehension, just like Yellow Starthistle in Texas.  All of this is to say: poor Tii had an irreversible condition and would never be able to eat again.  I called the owners to inform them of Tii's fate and told them we would wait to euthanize him in the morning so they could come say their goodbyes.  Unfortunately, Tii is also my first patient who died prematurely despite my best efforts.  I walked into the barn on Friday morning with a sinking feeling in my stomach when I realized my patient wasn't standing in the stall.  He had expired overnight, likely due to a fatal combination of stress, hypoglycemia, and muscle wasting.  His poor body couldn't handle it anymore and I just felt awful for the poor guy.  Again, I called the owners.  She was already on her way.  When she walked into the barn my first instinct and action was to walk over, hug her, and apologize.  She hugged me back and continued hugging me after I released.  She said "It's okay, I know you did your best and I thank you for that."  Another first: receiving praise from an owner when I feel like I went about everything all wrong.  Wow.  Humbling.

Friday was also my first time to castrate a horse, diagnose deep pyoderma in a dog and convince the owner that their dog needed to receive 6 weeks worth of antibiotics, and have an owner blame me for something erroneous simply out of personal frustration.  All-in-all, it was a very productive day!

The biggest thing though, was that this week was my first time to be a solo veterinarian at a practice.  I couldn't have done it without the support of the brilliant veterinarians who are just a phone call away and a staff that constantly has my back when I need them.  Each day brings new experiences which remind me to be appreciative, humble, and joyful for my lot in life.  I'm so thankful to be in a place which is forcing confidence upon me.  It's a personal hang-up of mine that is slowly being chipped away at on a daily basis.

Week One: The Learning Curve

I've come up to the clinic tonight to take advantage of free wifi and check on a couple of our in-house patients.  Both patients are female dogs.  One is middle-aged with a broken pelvis and nasty gash from being hit by a car, the other is a 6-month old who is trying her best to tough out the cursed parvovirus.

It's been a little over a week since I checked in last, and looking back over the past 8 days all I can say is: phew!!  I've seen and learned a lot over this past week!  The mission team was here rocking socks Monday-Thursday.  We tackled the surgeries and attended to walk-in appointments Monday, Tuesday, and Wednesday.  The cases ranged from standard vaccinations to severe corneal ulcers (yep, that's the eyeball) to abscesses, arthritis, gastrointestinal upset, ringworm, etc.  We were clipping right along and getting into the groove of the clinic.  I woke up on Thursday in a great mood!  It was one of those productive, hyper, smiley moods that makes you appreciate the little things in life and work efficiently.  It was perfect for the day that Thursday would become.  The entire week's schedule was full before we even made it to Window Rock, but as rez time would have it, many people weren't able to bring their pets to the clinic throughout the week for one reason or another (too far, too expensive, dog ran away for a few days...).  Until Thursday.  EVERYONE showed up on Thursday.  After 8 spays, 6 neuters, random walk-ins, and 14 hours of non-stop action, my energetic mood deteriorated and the mission team went through several states of delirium. After leaving the clinic we had grand plans of eating dinner, drinking a beer, and going to bed promptly so we could wake up the next morning and watch the sunrise with the rest of the mission team.  Instead, we ate dinner, drank a couple beers, and played grade school card games until 3:00am.  It's funny how second winds hit.  Lauren was the only one committed enough to go on the sunrise hike.  The rest of us enjoyed staring at the backside of our eyelids until mid-morning.

Once we all finally rolled out of bed on Friday we drove up to Chinle to visit Canyon de Chelly (pronounced "shay").  It was a beautiful afternoon hike complete with spectacular views, ruins, caves, and climbing.  It was a rewarding end to a productive week! :)


Spider Rock in Canyon de Chelly.



White House ruins on the floor of Canyon de Chelly (1000 ft. below rim).



  By Saturday morning the entire mission group, aside from Lauren, had left for their 14 hour drive back to College Station, TX.  Lauren and I enjoyed a leisurely breakfast and decided to make our way down to Arizona's Apache-Sitgreaves National Forest.  We stopped for lunch at a local restaurant in Eager, AZ and received a "Gig 'em Aggies!" greeting from a man in the parking lot.  My "Texas A&M Veterinary Medicine" decal gave us away.  Both of our sandwiches were delicious, and they seemed even better when we learned that our lunch ticket had been covered by our new Aggie-loving friend!  We never caught his name, but he said he was originally from San Angelo, Texas and had 2 daughters who just graduated from college.  He said they were dirt poor and agreed that we probably were too.  He was right.  His generosity was uplifting and very much appreciated!  After lunch, Lauren, the dogs, and I arrived at Big Lake where we spent the weekend camping, hiking, and generally chillaxin'.  We popped my hot pink tent at a campsite with a waterfront view.  It was perfect!  The weather was great, the dogs were happy to run and swim, and the views were stellar!

Cheyenne & Seu awaiting the commencement of the "retrieve the stick out of the frigid mountain lake" game.

Saturday night's sunset over Big Lake in Apache-Sitgreaves National Forest.

Sunday's hike: Lauren, Seu, Cheyenne, and I at the top of Big Lake's ranger lookout station.

The four of us returned to Window Rock on Sunday afternoon feeling refreshed from our outdoorsy weekend.  Lauren and I cleaned up and headed into Gallup, NM (the closest sizeable town) for dinner and a movie before she left for her summer road trip adventure.  More perfection.  :)  We saw Disney's "Brave" and I had to restrain myself from calling my mother at midnight to apologize for being like Merida.  It's a good thing I didn't call; otherwise she would have undoubtedly been very bear-like.  You'll have to see the movie to understand those sentences.  Sorry.

And so here we are, partially into a new week!  So far, so good.  I feel incredibly lucky to be surrounded by an amazing clinic staff who laughs at my jokes and not at the stupid things I do every-now-and-again.  I am starting to respond to "Dr. Mills" and enjoying breaking my title in like a new pair of shoes (though I still prefer being on a first name basis).  I have my own corner in the vet's office and am beginning to establish a sense of professionalism in my mind.  As long as I have a coffee cup in-hand I feel legit.

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!

Off We Go!!

Cheyenne and I left Dallas to head West, well, South first, technically, on Wednesday, 6/13/12, at a later time than was originally scheduled. For those who don't know my packing habits: I hate packing. A lot. I tend to procrastinate and end up packing too much due to feeling overwhelmed--which leads to delayed trip embarkations and heavy baggage. I tried to tailor my urge to pack everything I own for this trip though, and I'm proud! The 5-week packing list was narrowed to this:

...we'll see if it ends up being too much or too little.  Either way, the first two pictures packed down into this!:

Cheyenne and I spent 2 nights in Austin with Kayley, my former roommate, who is settling into her new apartment and new job.  It was a great 2 nights/1 day, filled with Home Depot runs, painting, touring Kayley's new clinic, and eating at wonderful restaurants!  I can't wait to pass back through!

On Friday, 6/15, Cheyenne and I loaded up at 6:45am and made the 10 hour trek out to Las Cruces, NM.  We were able to break-up the monotony of I-10 by taking a breather in Ozona, TX to visit family over the lunch hour though, phew!  In Las Cruces we stayed with a dear family friend, Judy, who treated us to frozen custard after dinner; Cheyenne thoroughly enjoyed hers and was jonesing for mine afterwards:

We arrived in Window Rock, AZ, capitol of the Navajo nation, at 5:00pm on Saturday, 6/16, and met up with the rest of the mission team.  I should take this moment to explain why I was inclined to spend the first part of this traveling internship experience on the Navajo reservation.  I was a member of an organization called the Christian Veterinary Fellowship (CVF) throughout vet school.  In early 2012 I was approached by CVF's mission coordinator with an opportunity to serve on a veterinary team with a local church's mission trip to the Navajo reservation.  There are many things I want to learn over this next year, how to be a better advocate for Christ through my occupation is one of them.  It was perfect!  I signed up almost immediately and managed to persuade my roommate, Lauren, into coming too. :)  So now, here I am--one of two veterinarians on this mission with a team of 4 vet students.

Here's the catch though: the mission only lasts for a week, then everybody else goes home.  I'm planning to stay here until mid-July.  And I just found out, today, that the veterinarian who usually runs the Navajo vet clinic gave birth to a beautiful healthy little girl yesterday and will be out on maternity leave for the next few months.

I guess we got here at the right time for the animal patients of Navajo!  I guess I'll be spending these first few weeks learning trial-by-fire.

Any first job is nerve-racking, but I'm especially anxious over the fact that I'll be the primary active veterinarian at a clinic I was just introduced to yesterday.  It's going to be tough.  It's going to be humbling.  Ultimately though, it's going to be an unforgettable experience which will test my character, bring great amounts of joy, and provide a stepping stone in the right direction.  We (myself and the mission team) start tomorrow.  Wish us luck!





I'm a what??

Well it's been a week since graduation, and let me tell ya, it still hasn't sunk in that I'm a doctor.  An actual doctor.  Like, I will never go by Ms. Mills again, DOCTOR.

The best metaphor I can come up with is this: You know the feeling you get at the very beginning of an unexpected rainshower?  How you are intensely aware of each small raindrop that lands on your skin and you know at some point, if you wait long enough, you will become drenched?  That's how the reality of my present and future responsibilities is hitting me.  Small doses of clarity hit me intermittently every few days but the over-riding feeling is that nothing has changed.

The first time it occured to me that my title and thought process were set to change was at graduation, when our dean reminded us that we entered the building as students but would be leaving as colleagues.  Another dose of reality came through at breakfast on Sunday for no particular reason.  I'm glad the shift reveals itself intermittently; it makes the process easier and allows me to maintain normalcy while savoring the anticipation of change.

Maybe I'll feel drenched soon.