A failed surgery… Independance Day

I live and study in Slovakia, my girlfriend is Polish, and I am British. This was all possible because of the EU. I’ve worked with orangutans in Hungary, Dolphins in Germany, Tigers in Slovakia, Penguins in Austria, and dogs and cats in France. This was because of the EU – I can travel freely within Europe, I can live in Europe, I can study in Europe.

Did you know that some countries do not charge tuition fee’s like the UK? Or that in some countries tuition fees are considerably cheaper than the UK. In fact until yesterday mine worked out around £6000 a year… With the cheap living costs of eastern Europe I am saving thousands a year of student loans and grants that are “normal” in the UK. What’s more, I am doing this only because I couldn’t get the support I needed to study in the UK.

Did you know the only time I ever queued to enter a country was when I came home to the UK… Yes, every country welcomed me with open boarders, yet I had to request permission to enter my own country.

Sadly today all these opportunities have been taken away from other young people.

Why?

Because the government chose not to include the EU in the education that people receive in schools in the UK – unless off course you are able to afford private school. Why is this important?

When I step up to the operating table I must be confident – I must know the surgery, I must know the complications, and I must know the anatomy. I must know the tissue techniques – how I can access what I need – and how I can put it back together again to restore function. I must know the instruments and techniques for the tissues I am working with – suturing a spleen is different to suturing skin. I must know the drugs I can use – and those that I should avoid – and the reasons for this. Before I step to the operating table I will try to find as much information as I can – xrays, ultrasounds, CT, MRI, blood tests, biopsies…

Now the government chose to stand you at the operating table – with the simple choice of removing or leaving the EU. They tried to scare you that the patient would die if the EU was removed because it was the heart. They scared you that the patient would die if it was left because it was stealing all the bodies energy. What did you do? What was the right decision?

Well that patient is now in intensive care and no one knows how to treat them. Not because of you or your decision. Because the government decided not to prepare you. Because you did not receive the education you deserve or required to be at that operating table.

The government failed you. It failed the patient.

Vet Festival 2016 – Day 2 Roundup

Sometimes you have that feeling where you know it’s the last day and you don’t want it to end. This is how I woke up this morning, excited for what I was to learn today, yet sad that in a little over 18 hours it was all going be over. I am hungry to learn, and every single thing I learn here will help me become a better vet.

Today started again with Prof Nick Bacon talking about thoracotomies which is where the chest is opened through the space between 2 ribs. This is normally used for surgery on the heart or lungs and sometimes just to remove tumours from within this space. The amount of information shared in this session was incredible – my take home point however was to consider all information and anatomy to determine the surgical approach. Sometimes it is easier, less painful and more sensible to make an approach through the abdomen under the rib cage.

Dr Philipp Mayhew talks thoracoscopy

Philipp Mayhew then again took the stage to look at how to work on the chest using a minimally invasive approach. Unfortunately with the size of the animal you are limited in what you can do with a key hole technique as things such as surgical staplers to remove a lobe of the lung are too bulky for smaller patients. However the ability to approach the chest with this technique does reduce the post-operative pain and improves recovery immensely as you are not pulling the ribs apart. In humans doing surgery thoracoscopically instead of open thoracotomy results in less pain, drainage, sepsis, pneumonia, and death.

Dr Clare Rusbridge talks chronic pain

After this I continued with Dr Clare Rusbridge – one of the best speakers I have ever come across who makes complicated things really simple. Today it was about chronic pain, syringomyelia and chiari-like malformation. I’d tried to learn about pain myself, however it is something really difficult to wrap your head around as there are different pathways and receptors. Here Clare spoke about the pain in context of the Cavalier King Charles Spaniel which due to bad breeding often suffers from these two painful conditions which affect the brain and spinal cord causing chronic pain. Chronic pain cannot be controlled with normal medicines as these do not act on the pathways activated with chronic pain.

Dr Laurent Findji on skin resconstruction

The next lecture was especially interesting for me as I had spent a few days in practice at the Fitzpatrick Referrals Oncology and Soft Tissue Hospital with Dr Laurent Findji. Laurent now was talking about skin flaps and reconstructive surgery. This is especially important in oncology surgery where you need to have the confidence in putting it back together again to cut loads of skin and tissue away to remove the entire tumour. In some human hospitals for oncology there are separate surgical teams for the removal of the tumour and reconstruction afterwards so that fear does not prevent removal of all cancerous tissue.

Prof Noel Fitzpatrick Limb Amputation vs Limb Salvage

Prof Noel Fitzpatrick took the stage again to discuss limb amputation vs limb salvage. This is something that is very possible now, however the question has now become just because we can, should we? This is usually required as the results from trauma or bone cancer, an important point to note here is that if a suspicion of bone cancer is there and limb salvage is an option then incisional biopsies should be avoided to prevent spread of tumour cells.

Sir Christopher Evans keynote Vet Festival 2016

The conference keynote was given by Sir Christopher Evans, a scientist that has been amazingly successful in turning science to profit. Nature is amazing, and yet it is something that is not really well understood, and Sir Christopher shared his story on how he used his knowledge combined with nature to create products that were in demand. Not once, but again and again. It was an inspirational story, and left one with much to think about.

ONE Live Concert 2016

The day ended with Prof Noel Fitzpatrick inviting everyone to join him at the ONE LIVE Festival to celebrate the difference that vets, vet nurses and everyone else in practice makes to the lives of animals every day. This is a reminder for every single person in practice out there that people care about the difference that you make every single day!

Vet Festival 2016 – Day 1

Turning up to a field you’d normally be expecting some farm work, however this wasn’t just any field, for the next two days this was the home of nearly a 1000 vets and vet nurses attending the second Vet Festival.

Arrival to the vet festival 2016Last September I was invited to join the first ever vet festival – and this year I had been invited back again. The passion last year for giving solid information that can be implemented the minute you arrived back to practice was amazing and so I was extremely excited to be again. This time it was bigger and better…

Prof Nick Bacon LaparotomyThe day started with Prof Nick Bacon talking about laparotomies where the abdomen is opened with a scalpel for the surgery to be performed. This was complimented by Philipp Mayhew who then spoke about laparoscopic surgery where it is done using a camera through just a small opening in the abdomen.

Micro hip ball and socket joint replacement implant

One of the benefits about being at a festival is the exhibitor village, and today was no exception taking a little while to go round and talk to people is always worthwhile. Today I found myself spending some time with BioMedtrix who make implants for joint replacement. A lot of veterinary companies offer technical backing to their products which is essential – and so I ended up with an introduction to joint replacements. The implants here are hip replacements for small dogs and cats – you can see just how small these are and how the small bone is that they will go into…

Securos surgical tta cage and plateLast year at Vet Festival I was introduced to external fixation in a workshop with Jerry O’Riordan and Freelance Surgical which was pretty cool. This year it was Centaur Services running the practical zone and I decided to take a look at an alternative technique for cranial cruciate ligament repair. I’ve seen MMP,  TPLO, and TTA Rapid already so here was a new technique with the TTA principle however with a different style of cage and plate. The Securos Surgical Cruciate Repair system has a smaller profile cage which is inserted into the bone to change the angle, and then a plate to fix it into position and support it. The main benefit here is that it can revised easily later on.

Prof Noel Fitzpatrick discusses computer modelling for surgery

The day ended with Prof Noel Fitzpatrick talking about Wobbler and lumbosacral diseases in the dog. This can be very painful and so is something that really needs attention – however is a very complex set of conditions to treat often requiring surgery for which there are many options. Something that Noel brought to the front of the conversation is computer modelling for the best surgical outcome, being able to plan the surgery and then test the outcome before doing the surgery is something that will reduce the risk of surgery. However such a thing will not remove the risk of surgery as there are a lot of variables involved including staff, facilities, instruments, and most important the rehabilitation.

The evening finished with a private festival just for conference attendees – The Vet Festival which was really cool and a chance to relax with some amazing bands.