Comments from the 143rd Annual AVMA Convention, Honolulu, Hawaii
For the record all quite annotated, because I’ve been spending all my time being a student instead of sitting around thinking of things to write, but there are a few comments I feel it necessary to make.

Saturday July 15th 2006
Now I’m ready to take notes although I think they’ll probably be pretty gibberish.

Observations from the first day of being a combined tourist and conventioneer.

Sucks. Don’t ever want to do it again because all I really want to do is to wander down to the beach and lie in the sand either sun or rain bathing depending on what is coming down out of the sky.

Had my fill of being a fuckin’ haole, eaten plenny plate lunch even in the last 24 hours. Want, well, I want more time. I want to be at home, I want to be here and playing or I want to be somewhere that is considerably less interesting than Hawaii to learn all this cool stuff. Why do they insist on putting conventions in salubrious locations? I wouldn’t even be this restless in Seattle. Denver was fine because I had no means of getting around on my own, Minneapolis and Baltimore were good because I had no familiarity with the area, but Hawaii for business sucks.

Sunday July 16th, 2006
The whole day was spent without computer access. I am now most thoroughly spoiled, the one day I’ve spent at a convention with a computer has permanently spoiled me for taking notes any other way. It’s so much easier to let my fingers pay attention to what is on the screen and let my eyes and brain pay attention to the speaker. There’s no, read NONE, table space in the great majority of the lecture halls and if you want to take notes you balance your note taking device on your lap. Okay to do with a notebook, but very difficult, to say nothing of nerve wracking, if it’s a heavy-ish piece of equipment that is EXPENSIVE and a well beloved piece of equipment that belongs to your husband.

Besides, it’s kind of cool to be sitting there typing out notes while everyone else has paper and pen.

Better to be here today than it was yesterday. The big problem with yesterday, I think, is that I was touristing first thing in the morning (some really cool garage sales and mighty malasadas from Agnes’ bakery) and then had to go and sit class. Today it was get up at odarkthirty and come to class with the promise of having the afternoon off past 1500. As I have done nothing today except for going to class it’s not as irritating.

I have seen a few faces that I recognize, mostly from other conventions, but I did meet up with one woman that I know. Ran across Denny Koontz who used to work for one of our sister hospitals in Lynnwood and who now works for a very busy practice in Portland. Was chatting with her, telling her about how things have been going at 5 Corners (where she has worked on occasion) talking about how we were going to be getting this new medical director named Joel and the guy sitting next to me piped up with “Do you mean Joel C&*(&(?” (name changed to protect the innocent). Stunned into insensibility, I said “Yes” and it turns out that he works for the practice from where Joel will be coming. And they didn’t know yet that Joel was looking for another position.

Great.

3000 friggin veterinarians at this bloody conference and the one who happens to overhear me talking with a friend about our new medical director works at the exact place from said medical director is coming. I hope that he will keep his mouth shut.

Why Modern Surgery is Way Cool
I try, at CE conferences, to do a couple of things. I try to go to lectures that I think will be practical for me, i.e. things that I think have some application for me in practice. I try to go to lectures that are about things that I think we could add to the services we already offer (new surgical procedures, new treatment options for commonly seen diseases etc.), and I try to go to lectures that are way above my head. The way above my head lectures have dual purposes, the first is to see how far above my head they really are (and I’m frequently surprised that they’re not as much as I think). The second is to update myself on what sort of cool shit is going on in the profession.

Today’s way above my head lectures were given by two different speakers, one from UPenn, the second was one of my small animal surgical professors from WSU (who is currently at Tennessee, yes, this sentence does make sense).
And they were SO COOL!

UPenn dude was talking about coil embolization of portosystemic shunts. I’ll translate that into English for you non-medical people. He was talking about how to block blood supply in areas where blood supply shouldn’t be. And the way they’re doing it at Penn is to, with a long arterial catheter like they use in angiography and angioplasty in people, place little surgical steel or platinum springs in the abnormal blood vessels causing the blood to clot and the vessel, eventually, to collapse. This is cool.
What is more cool is that they can also thread these enormous long catheters into blood vessels in tumors to block the blood supply to the tumor and so kill it from the inside out. This is really cool, but what is the coolest is…
Before they block off the arterial blood supply of these tumors they’re injecting chemotherapy agents into the tumor and then once the blood supply is blocked the chemotherapy agent has no way to get out of the tumor thus allowing for larger doses to be delivered directly to the target tissue with fewer systemic side effects.

This is very cool.
And they’re blocking the arterial blood supply with surgical grade superglue.

And on the subject of superglue……
That was what Dr. Tobias (my prof from WSU) was talking about. She has been doing some research studies on superglue closure of various internal lacerations (lungs, kidneys etc.) Her stuff was pretty darn cool, but the coolest part of her lectures was….

The superglue that they’ve been studying? Not any fancy surgical cyanoacrylate. They’ve been going to WALMART to get their glue.
The exhibit hall is, as always, so full of hucksters that you can’t turn around without being offered a brochure, a pen, or what have you. This year’s gimme of choice?

iPODs.

I have signed up to win an iPOD at about fifteen different booths. Now granted, Andrew gave me one of my own, a 4 gig Nano for my birthday, but what I’m trying to do is to win one so I can fill it full of books on tape for my Mom who will be in hospital for 3 days later this month having a knee replaced.

iPODS, lots and lots of iPODS.
Also beach towels.

17 July 2006 (Monday)

Surgical lectures all day today. I’ve been learning about skin grafts and skin flaps and new surgical methods for treating gastric dililtation and volvulus. For the non-medical readers, a GDV involves a dog’s stomach becoming bloated (food, gas, what have you) and then taking a 180 to 360 degree trip around its long axis thus effectively twisting the esophagus and the upper part of the small intestine. Surgical emergency. You have to get these dogs into surgery within a few hours to decompress and derotate the stomach (and frequently the spleen) or the lack of blood supply causes irreparable damage and your patient dies. In twelve years I’ve only ever been presented with two of these; one was euthanized, the second I had help with. For some weird voodoo reason they don’t seem to happen during the day and so the night shift sees all of them.
I am pleased to note that we are treating our GDV patients in much the same method as they are being treated at the university hospitals. Our procedures, the materials, drugs, and monitoring abilities we have available are similar or exactly the same. I picked up some really good tips on how to deal with the surgical aspect of it, I hope I can remember what I need to remember when it comes to being presented with the next one.

One or two mentionable things today.
Dude that was doing the “moderating” for today’s surgical lectures should have been upended in the Ala Wai (I’ll get to that in a minute) after his first introduction. Now granted, I’ve been a little hypersensitive and grouchy lately, but be said the word “BASICALLY” about three times a minute. It basically, was basically the most irritating thing I’ve basically heard in a very long time. No joke. That sentence was as similar as I can get to his introductions of the speaker without getting into specifics about the speaker, or the moderator’s, name and background. What astonishes me is that (according to his own information) he has been moderating lectures for AVMA conventions since 1998 and no one has mentioned to either him or the Powers That Be that he’s REALLY ANNOYING.
And as regards the Ala Wai……..

The Hawaii Convention Center has really been the loveliest venue for one of these things that I’ve ever encountered. Big, air conditioned rooms, airy, wide open courtyards with wonderful landscaping, doves and mynahs flitting about, plenny water fountains, and thoroughly sufficient (outnumbering the facilities for the men about two to one) ladies’ rooms. The third floor, where I spent most of the day today, has an enormous central atrium surrounded by lecture rooms. Follow this atrium to the end and you find yourself in a courtyard that opens out into a garden and a landscaped terrace for the smokers. Follow the terrace down and you’re right along the path that borders the Ala Wai. Frequent visitors to Waikiki over the last several years (to decades) will understand the humor of this lovely vista, of which visitors are encouraged to take advantage, ending at the Ala Wai. For those that aren’t familiar, I’ll elucidate (FINALLY).
The Ala Wai is a canal that runs through Waikiki. In its various incarnations it has served as the “driveway” for various canoeing clubs in and out of the harbor, a place for locals to fish, and a large, open air SEWER! (I said the locals fished there, I didn’t say that they necessarily eat what they catch). As recently as this spring, when Oahu was experiencing one of the longest stretches of rainy days in history (forty or forty three days in a row depending on whether you ask Tony or Joan), it became a death sentence for some poor schmuck who fell in and went on, within a few weeks, to develop fatal necrotizing fasciitis.
“Welcome visitors to the Hawaii Convention Center! Please make use of our remarkable conference facilities, enjoy our lovely gardens, and don’t forget to visit the largest source of Flesh Eating Bacteria on the Pacific Rim!”

I should have gotten a photo, but all I had with me was my camera phone and I’m not sure Andrew has yet figured out how to transfer photos from my phone to the computer.

And so the day is done, I’m done with my conferencing and I’ve learned lots. I should be able to use a good deal of what I’ve learned and I’ve filled at least half the hours I need for continuing education over the next three years.

Tomorrow we get to play!