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.
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.
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.
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 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.
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.
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!