Sunday, July 3, 2016

Until next time India!

Getting dressed for my last day at the polyclinic was bittersweet. When I went down and ate breakfast it finally hit me. I was going to my favorite place for the last time this month. It didn't help that Raja was thirty minutes late to come pick me up (a huge misunderstanding occurred). When I finally arrived they were treating a puppy for parvo (seems normal right). The owners were policemen and insisted on buying the antiserum for parvo to insure the puppy would live. The antiserum is incredibly expensive, up to 300 US dollars. Everyone at the clinic actually got excited for a parvo case because it was going to be treated in the best way. During its treatment another case came in. A dog had a swollen face which Sangamitra assumed it to be a plant allergy. The next few cases were treated with fluids and antibiotics (the usual). We had two small surgeries today, one a tumor removal and the other one a spay. The tumor was very small and presumably benign. It was removed with a laser!! The skin burned off and the surgery was done it just a few minutes! The spay was actually pretty interesting. The dog was apparently pregnant (but not very far along) and the ovaries were cut our very quickly resulting in another speedy procedure. Before I left, I made sure to take a picture with everyone at the clinic and get their information. After this trip I cannot imagine not coming back to the polyclinic after the great memories and lessons it gave me.

The lucky pup receiving the antiserum 

The dog with the possible plant allergy

If you look closely, the lil pink things on the paper were the tumors in his mouth


I went to the private clinic early today to observe a mammary tumor removal on a rottweiler named Susie. The tumor was tricky because it wasn't just one large hard mass, it was more flexible. The tumor was spreading and the surgery would take longer to insure all of the mass would be eradicated from the body. For this surgery, I had to wear a scrub top, a mask, and a cap. I felt almost like a doctor! The surgery went better than expected and Susie recovered from anesthesia quicker than I've seen any dog recover at the private clinic. Granted she wasn't moving and couldn't really get up but she did try and that is a sign of recovery! The next few cases were my favorite kind: healthy puppies! I got so many puppy kisses to the face, it was glorious!! The last case I saw before I left was a mastiff that was four years old. He had surgery last year to remove these masses from his elbows (refer to the picture). He came back because the masses grew back in one years time. They are going to send it in for a biopsy to see what it really is so they can treat accordingly. I made Saranjeevi (another great doctor), Marty & Manny (best vet assistants) take a picture with me before I left. It was surreal to finally leave but again I am so thankful for all they have taught me throughout this experience. This opportunity has really opened my eyes to what I really want to do in life.

I looked like a total goob but I felt like the real deal. 

Masses on the Mastiff 

You can't tell from this picture but I really think they did like me! 

When I got back Solomon took us to this really nice hotel for dinner. It was incredible and they were actually playing English songs! It was a nice, relaxing way to end the trip. Saturday morning, I packed up all my things and headed over to the polyclinic one last time to say goodbye to the doctors I missed Friday. After that I walked around campus and Trichy a bit more (my way of drinking it all in before I left). Before we headed to the airport, Sahana, Sangamitra, and Dr. Prasanna stopped by the college to say goodbye. Sahana and Sangamitra gave me a lovely ring with a small flower on it and wrote on the box, "to our lovable Jessica". I couldn't be more thankful for these people. They accepted me from day one and never stopped trying to make me feel included. I would have got them gifts but when we went shopping they kept telling me that I was their sister and family doesn't need to get each other anything to say thank you. Little do they know I will absolutely be sending a care package or two to the polyclinic. When Prasanna showed up he gave me a really nice watch! I was surprised and thankful because never in my life have I owned a nice watch. After we took a few selfies and I gave Prasanna an awkward hug (people don't hug here). He told me that his wish for me was that I get a seat in one of the vet schools next year. He said it was all of their wishes and it will be true. I'm not going to lie, I got a little bit choked up. I cannot put into words the impact this trip has had on me. Reflecting back on moments like these I can't help but smile and just say thank you. This journey has opened my heart and mind to so many different things and I can't help but feel I left a big piece of my heart in Trichy. I will keep you all posted on how life is back in America but for now I am just going to try to survive these flights and reflect on all the good this month has brought me. 
Our last dinner in Trichy! 

My little family in India. 

Until next time India! 

Thursday, June 30, 2016

The importance of timing

The polyclinic today was very slow. We had another case come in similar to yesterdays. The mother goat was carried in and she was so exhausted she could not even hold her head up. When Dr. Prasanna told me they would be pulling kids out, I was very excited. After yesterday's adventure I really wanted to see it again and it looked like I would be able to. Little did I know but this case was very different than yesterday's case. Apparently the goat had endured some kind of accident and the fetuses inside were dead and decomposing. The infection in the uterus lead to a very unpleasant smell and a cesspool of danger for the mother. Sahana pulled the first goat out easily and the bones seemed nonexistant. The kid looked almost unrecognizable as a goat. I then watched as she tried to pull the other one out. The thing she pulled out was a pink mass which I later found out ws a part of the mother. The uterus had been puncutured and part of the mother goat was flooding into it. That's when people started moving to get the mother more fluids and try to save her life. The infection which I believe they said was mastitis would be able to kill the mother in minutes if the uterus burst. It took less than five minutes for the mother to die. When I asked Sahana the cause of death she said that the other fetus inside the goat had decomposed to the point of just being broken bits of a body and that one of the fragmented bones must have punctured the uterus when she was reaching in and grabbing the first fetus. When I ran into Prasanna he asked me why I looked so dull. I said because of the death and he explained how it was normal for the fetus to die. I had to interrupt him and tell him that the mother had died and he was shocked. When he went and examined the body he told me that she could have been saved if they had just brought her in one day sooner. I think as a vet, timing can be one of the best and worst things when treating a case.

The mother goat, obviously very exhausted

After work today, Sahana and Sangamitra took me shopping! I am not going to lie when I say I love shopping here. Everything is so afforable which can be a little bit dangerous. It's easy to reason with yourself when buying something once you convert it into dollars! It was so nice going shopping with them because it was just like hanging out with some friends (who love the earrings here as much as I do). We were shopping for over three hours by the time we were done! I am incredibly thankful for these lovely women. They kept telling me not to forget about them when I get home which was so sweet and I promised I wouldn't as long as they sent me their wedding invitations in a few years. Tomorrow they want to take me to a temple in Tanjou (I hope it works out)! 
The squad

Wednesday, June 29, 2016

What a day!

Today was one of my favorite days! When I got to the polyclinic, an amputation was being performed on a kid from the knee down by an intern. Dr. Ganesh Kumar apparently let him do it and I do not know anything about amputation but I could tell that the procedure wasn't going as planned by the look on the intern's face. The bone of the leg was still exposed by the time he cut half of it off. He was then trying to sew skin together over the bone. I was talking to Sahana and Sangamitra about it and they both knew it was not the proper procedure but were keeping their mouth shut until Dr. Prasanna came in. Dr. Prasanna came in and at first did not notice what was going on but once he found it he started giggling. He was telling me that first off, the amputation should never be done with half of the leg still attached. An animal can learn very easily to walk on three legs but has a very tough time adjusting to three and a half. Because the amputation had already been started and the anesthetic was wearing off, he would just finish the leg and leave the goat with 3.5 functioning limbs. The first thing he did was move the goat to a clean table and then he tied off the top half of the leg with tubing to cut off the circulation. He acted fast while using a bone saw to cut off the remainder of the tibia. There was little to no blood when the bone was cut due to the lack of circulation. He then sewed up the skin and wrapped it up and it looked so much better. Apparently the other hind leg also had a fracture and at first Dr. Prasanna told the owner he should just send it to slaughter but get this, the owner wants to keep the goat as a pet and insisted that we do what we can to ensure a long life (statements like this make me love this profession). The other leg was casted and it looked great! I have high hopes for this kid and owner! The next few cases were routine, parvo and vaccines. The parvo cases are still shrinking and all the cases are returning patients on the way to recovery! After a while I stumbled upon my favorite case since arriving at the clinic. A goat came in because it had been in labor for over eight hours but had not passed her kids (seems normal but wait). She was administered some drugs to help dilate the vaginal wall. After a while one of the interns got to put his hand in the goat and check where the fetus(s) were (goats usually have kids in multiples). I thought this was routine so I walked away for a few minutes but when I walked back he gestured to me to come see and he had pulled the head and one of the front legs out of the goat but was struggling to get the rest out. This became an intense game of tug of war between the intern and the vagina. Finally after several minutes he pulled the goat out which was dead due to a genetic disorder which causes a fluid build up under the skin. The front half of the first kid looked normal but the fluid had built up around the back area making it look like the bottom half was full of water. When I looked back up I could see a small hoof coming from the momma goat. The intern pulled for a good ten minutes without any progress. Seeing the problem, Prasanna put some gloves on and got into the goat. After some time they were able to grab the head and an arm. This fetus had the fluid buildup around its face, giving a bull frog appearance. When pulling it out, the leg had too much tension and burst off of the fetus! I should let you readers know that the first two babies were and had been dead due to this disease. Getting this fetus out was an obvious struggle but after ten mins they did it. The excitement had died down a bit by the time they had reached for the third fetus. Dr. Prasanna was assuming that it would also have the disease but to his and all of our surprise when they pulled it out it started moving. It was alive and completely normal! I was cheering loudly when I heard it cry and got made fun of a bit by the assistants afterwards but I did not care. Seeing a live baby after two dead ones were pulled out was an amazing feeling of surprise and relief. That case put me on a high for the rest of the day. After that the cases just trickled in but Sangamitra brought henna to pass the time and decorated the inside of my arm and hand. It is incredibly beautiful and impressive and she said she will do my other hand in the morning (yay)! 
 The leg before and after Dr. Prasanna.

The bloated baby giving an appearance of a bull frog. 

Dr. Prasanna, Dr. Ganesh, Vijay (doctor at the private clinic), and I headed off to a feast today at two. The drive was two hours long and we could only eat for thrity minutes if we wanted to be back at the private clinic in time. The drive there was actually really fun. We drove through a lot of agriculture towns and Dr. Prasanna explained to me what each plant was used for. We drove through a eculyptus farm and Prasanna informed me that eculyptus trees are often cut down because they hoard all the water and nutrients from the other plants. When we finally got to the feast, I found out we were late by two hours! Even so, we all sat down with our banana leaves (equivalent to a plate) and ate whatever they put in front of us. I did not each that much because I just wanted to try everything and did not want to risk upsetting my stomach but everytime I looked over, Vijay and Prasanna were finishing another plateful. Keep in mind that a banana leave is about the size of a food tray (if not bigger). Vijay is a tall skinny doctor and I kept asking him where he was putting it all! After a short feast we headed back. During the drive back Prasanna informed me that a serial killer had just been caught and he had killed six girls in one day by taking a knife and slashing a line from their mouth to the jugular. Half-way through the drive (without warning) Prasanna showed me a picture of one of the victim's faces. I shouted "What is wrong with you!" in between laughing he said, "I don't know, man. I thought you wanted to see it. I couldn't sleep after seeing it". I will never understand the humor here but for a while it was nice to just laugh at the weirdness of that moment. When we got back we just saw a few cases. Most were vaccines and one was a check-up for the lab that had a hematoma. The wound was cleaned and almost healed so Prasanna did not even wrap it up thinking it would be just fine. Not five minutes later the owner came back covered in blood. The dog had started scratching the wound and re-opened it! There was blood everywhere (what a doofus). It eventually got wrapped up and a cone was placed on the dog. What a day! 

Tuesday, June 28, 2016

My last Tuesday.

During breakfast this morning I was greeted by yet another American! His name is Chris and he is a professor at Davidson college. He teaches ecology and actually knows some of the people in the biology department at App. Seeing someone somewhat familiar in a completely unfamiliar place like Trichy is extremely refreshing. I wasn't able to talk to him too long but he did say this was his fifth time coming to India (so jealous). When I arrived to the polyclinic it was yet another slow day. One of the more interesting cases of today was a dog who had developed a small infection due to a misinjection of a vaccine. The vaccine was supposed to be given subcutaneously (under the skin) but was given in the muscle instead. The infection was only midly irritating and did not pose much harm to the dog. Dr. Prasanna said that if he is given antibiotics it will go away in a matter of days. The owner said the mistake had been done by one of the interns at the polyclinic and instead of scolding them Dr. Prasanna just laughed it off. He said that if he scolded them for every small mistake they would become fearful of him and hide their work (good point). The rest of the day was full of vaccines and x-rays. Good news is that there were only four cases of parvo today at the polyclinic! Although days like these can be a bit boring, I still wouldn't want to be anywhere else. 
The little guy with the man-made irritation

Before heading off to the private clinic, I walked around Trichy with the other Appalachian student for a couple of hours. Walking around this place makes me realize how much I've grown to enjoy it here. I think that it will be hard to leave but I have no doubt that I will find my way back here. At the private clinic there were two cases of parvo and two cases that were there for vaccines (both sets were adorable puppies). The last case of the day was a puppy who had a broken leg and needed a splint. I had seen a splint done in the polyclinic using a stick and cotton. In the private clinic, Dr. Prasanna hand made the splint out of a cast. He said that he would not use a straight splint because it does not encourage the correct architecture of the leg. Seeing him make the splint and the final product was astonishing. It was such a simple way to preserve the shape of the leg. Not a day goes by that I am not impressed with the procedures done in each clinic. 
These cute siblings were here for vaccinations 

She was being treated for parvo. 

This is the hand made mold for the splint

The fully functional product!

Monday, June 27, 2016

Cute as a button!

This morning I walked downstairs after four hours of sleep and came face to face with another Boonie! He looked at me for a second and at first I thought he was one of the french guys we heard were coming for the semester but then he asked me if I was from appstate. It is such a relief to see another semi-familar face in a place so different. As we ate breakfast I gave him the low down of our trip here so far and asked him his hopes in studying here. After a quick breakfast it was off to the polyclinic. The first case was familar, it was the doberman that came in last week with GDV (x-ray seen on a previous post). He ended up having the surgery at a bigger hospital but because they did not give him the right dosage of antibiotics he developed an infection. He looked like he was in a lot of pain and the owner was obviously distressed. I cannot imagine how it must feel to send your dog to a sterile environment and there still be problems developing post-operatively. He will be treated with a series of heavy antibiotics for three days and if it does not make a difference Dr. Prasanna agreed to open him up. The next case we saw was a tumor on a small older dog. It turns out that the tumor is treatable with chemo. The cancer was caused by a STD and will be treated once a week for three weeks. Today I saw a dog that was being treated for E. Canis (an aggressive bacteria infection). He was administered Doxycycline which is what Conner and and I are taking as an anti-malaria drug. The drug will upset your stomach if you don't eat food (a harsh fact I learned last night when it made me vomit in less than thirty mins after taking it). The next case was one of Hypopym, no blood circulation to the cornea. To get the circulation working Dr. Prasanna sewed a button on the eye to keep it closed. He said the button puts less pressure on the eye and is less irritating. He will remove the button in a week and if it hasn't gotten better he will remove the eye (wishing so badly I could see the follow-up). The last case before it slowed down was a foot amputation on a chicken who had developed gang green. No anesthetic was needed because the foot was not functioning and had no blood flow.

Button eyes! 

The foot of this chicken was close to falling off. 

When I got back from the polyclinic, I pointed Dominic (app student) in the direction of the ATM and finally napped. I rushed over to the clinic later in the day to see a castration! Dr. Prasanna informed me that it is much easier to do a castration than a spay because there is minimum risk and not as much blood. After the procedure, several puppies and kittens came in for vaccines. It is still so nice to see puppies that are healthy and parvo-free. Dr. Prasanna gave me some coffee tonight to help with the nausea I had been feeling today, I don't think I will ever get over how nice everyone is here.

Post surgery pic! 

Trouble in paradise

Here's the weekend recap! Okay, so Friday at the clinic was another slow day. The first case that came in was feline panleukopenia (the cat version of parvo). The kitten was smaller than the kidney tray that we use to carry the vaccines. It was in obvious pain, gasping for air and hardly moving. After giving fluids for five minutes the kitten died on the table. Sahana informed me that the difficulty that comes with treating cats is that they don't show pain. When they do show pain it may be too late. The next case was a dog that was here for a follow up appointment. His jaw and mandables were extremely swollen and has not been able to eat food. He was given another round of fluids and antibiotics and sent on his way. A doberman with a limp came in next. Dr. Prasanna did several physical tests to see if the limp was caused by neurological problems or a sprain/break. This test was done by pinching the toes of the injured leg and seeing the dogs reaction. If the head is turning in reaction to the pinch then the problem is not neurological. Good news, the dog did turn his head and the limp was determined to be a sprain which was treated with some painkillers. The case of the mammary tumor that was removed on the lab earlier in the week came back for a check up. The stitches were still firmly in place and there were zero signs of infection! Dr. Prasanna that it is because the owners are giving the antibiotics on time resulting in a successful follow up. During my time here I have found a common theme: it is critically important for an animal's well-being to have a caring owner (this component could mean life or death for the animal). The last interesting case of the day was a dog that came in and it's backside was completely covered in blood. No one knew exactly where the bleeding was coming from and Dr. Prasanna said we could not examine it until we administered an anesthetic. When a dog is in that much pain or distress a thorough examination can be difficult due to the unpredictability of the dog. After the dog was sleeping well, Dr. Prasanna started examining him. It turns out he had a rip in his anal cavity, Prasanna said this could've been done by someone throwing things at it (such as glass or rocks). He sounded very sure it was a malicious act but the good news is it was an easy fix. One suture and the bleeding stopped!

Rest in Peace little kitten. 

This is the guy with the swollen face and as you can see he is not amused with my picture taking. 
On the way to a clean scar! 
Where's the blood coming from??

On Friday night we took a bus for eight hours to Ooty. Ooty is very beautiful and full of mountains. Driving up the mountain was similar to riding up to Boone but much larger! When we got off the bus I felt a little bit nauseous. I shook it off and didn't think anymore of it until we got on the next bus to mudumalai (location of the safari). The bus ride was rough, I felt like a rag doll being dragged around every which way. I felt completely sick when we finally arrived in Mudumalai. I could barely walk without feeling like I was going to vomit and each step I took felt like I was carrying weights on my ankles. I asked Conner if we could just get a hotel as quickly as possible so I could lay down. The only hotel available (according to the guy at the reception center) was run by the government and cost 2500 rupees a night (compare that to the 600 rupees we spent per night a Pondicherry). At that point I didn't care what the cost would be I just needed to lay down on a bed for a while and happily paid the very large fee. When we got to the hotel and the manager directed us to our rooms my body hit the bed like a rock. I was desperately hoping that all I would need is rest to feel better but when I woke up I felt like I could hardly move (I was so weak) and I was covered head to toe in sweat. I reluctanlty dragged myself out of bed and we went down to the main lobby for a meal but I had zero appetite. I stuffed half a chapati down my throat and kindly asked Conner for some advil. By some mercy of God I woke up feeling so much better. What was coming out of me was not solid but I did have more energy. Unfortuntely by that time all the safari's were closed but we did meet some friendly guys who were vacationing for the weekend and offered to give us a ride around town. We stopped by a really huge lake that was absolutely stunning. On the ride back they offered to make us dinner and of course we accepted. The villa they were staying at was only half a mile from our hotel and the food they bought us was incredible (per usual). They kindly drove us back to the hotel after a few hours and we planned to catch the earliest safari in the morning. In the morning we got up and took the safari where we saw a hundreds of deer, buffalo, and a tiger. The tiger was by far the most interesting part (unfortuntely I did not get a picture). After the safari we went to elephant camp where we saw trainers feed elephants and ride them. Seeing the chains on the elephants is still something I am uncomfortable with so we left shortly after. For the rest of the day we hung out in Ooty. We went and saw the tea factory and museum in the city and scored some homemade tea and chocolates. We then went to the botanical gardens where the landscaping took my breath away. The flower arrangements they had prepared were incredible and there was even a design picturing the country of India using different shrubs. After hitting the market for a bit we caught a train back to Trichy which was cramped but cheap (you get what you pay for). Overall it was a unique experience I just keep wishing we had more time in this wonderful place!

Lots of deer on the safari

Elephant camp

Ooty mountains

Tea museum 
Look at this awesome thing! 

More incredible work at the botanical gardens

This tree is huge!! 

Thursday, June 23, 2016

Rainy days and elephants

As I walked into the clinic today and saw all the doctors sitting down at the table I gathered that today was very slow. Sahana told me that in the time she had arrived they had only seen one case and it was parvo. The reason it was so slow today was because of the rain. It was cloudy and cool all day today which was nice for me but was not enjoyable for everyone else. Dr. Ganesh Kumar said that people here are scared to drive in the rain so when there is a day like this one not many cases will come until it clears out. While we were waiting for some kind of rush, a couple cows came in for artificial insemination. Sahana inseminated a cow twice in a row correctly (this is a huge deal, this is actually very hard to do)! She was in better spirits after that which was nice because everyone else looked exhausted. Parvo case after parvo case after parvo case came in after that and by eleven o'clock, I was ready to never see another parvo case ever again. To pass the time, Dr. Ganesh Kumar took Sagamitra, Sahana, and I to see the local temple elephant. Trichy has three temple elephants in the area and Lakshmi was the one our clinic was responsible for. When we first walked in, I could not keep my eyes off of her; she was gorgeous. We got to see her molars, which I found out often fall out in elephants and will regrow. Also female elephants have really short tusks and males have the really long ones. Lakshmi is 25 years old and has been working as a temple elephant since she was 2. After a few pictures we fed her biscuits and she blessed us (booped us on the head). We headed back to the clinic and treated yet another round of parvo cases.
Left to right: Sahana, me, and Sagamitra 


At the private clinic the parvo and distemper cases flooded in. We did a small procedure for a hematoma on a lab, this happens when the ear of the dog fills with thick blood after irritation (why it is critical to keep your dogs ears clean). We have done this procedure several times in the polyclinic but it is done with so much more care and concern in the private clinic. The lab was actually under full anesthesia, everyone involved wore gloves, and there was an actual tube stuck in the ear to drain out excess fluid. Although this procedure is more favorable it costs over 150x as much as it does in the polyclinic and will result in the ear looking almost the exact same. In the polyclinic the ear will shrink after the procedure leaving a less than ideal result but still functioning. After this case it was pretty slow. Dr. Prasanna did inform me that in India it costs 900 US dollars to get an iphone! This is about the only thing that is cheaper to get in the US.
This girl is Susie and she was just in for a check up. Good news she is no longer having epileptic seizures! Yay for effective animal treatment! 

A happy outlook for this fella.