Tri-10, Wk08 - Day ???, Thursday, March 1st, 2012

Note to self: do not set calendar on keyboard or you will lose everything you typed....

Basically I screwed up and overlooked my 3rd and 4th competency board exams which means I get no credit for them but still need to pass comp boards to get back into clinic. I had Feb 14, 21 & 28 to choose from. I was going to go with the 28th but ...lost focus :(

Where's that list again?...

1. Senior Research Project - waiting for approval in the mail from IRB, Internal Review Board
2. Loomis, Internal Health Specialist program - next meeting is Sat 1-7 & Sun 8-2
3. Acupuncture - First weekend is coming up! March 4th & 5th. I think I might need a book and maybe $79 or so for needles??? not sure
4. Competency Boards - already screwed this up. Might want to shoot for the 13th or 20th.
5. Part III National Boards - March 25th!!! Keep working through the books, making flashcards and studying whenever possible. The matching feature on studystack.com is really nice when first learning a set of cards and I have an app on my phone to look at flashcards any other time.
6. Advanced Basic - I think I'm sitting pretty good right now. Just took the midterm
7. Differential Diagnosis - I have a midterm next Thursday in this class. Studying for this class will probably do the most with helping me out on Part III Boards
8. Office Management - we have some poster due next week. I have to find out more information about this.
9. Clinic - I guess this could start with an email
10. Marketing - this hinges on Clinic but, i've already talked w/ the Marketing director and met her temporary replacement.

Just remembered that I'm also signed up for a half marathon on April 15th... I should probably start running for that

AND...I'm still in that Lose to Win contest. not sure how much time has passed on that.

w/ the money thing I can still cancel Netflix since, it's not much good w/o the internet and was looking into Centero Research to participate in an upcoming study to earn some extra cash :)

Tri-10, Wk08? - Day ???, Wednesday, Feb 29th, 2012

I started a list yesterday which mainly pertained to areas I need to focus on with school. With any list I make up these days, they tend to be incomplete because I can't think of everything that's going on at one sitting. For now, it looks like I have 10 things in my list pertaining to school. I think financial (non-school) tends to weigh most heavily on my mind. Maybe I'll start with that.

Financial - I know I need to reduce my overhead. I've already activated my cell phone to act as a Wi-Fi Hot Spot for $30 per month which means I can get rid of my Virgin mobile Hot Spot which currently runs me about $40 per month. So, there's a savings of $10 and using my phone is more conveinent because I usually have my phone with me.

10:22 a.m. - Let's move these words into action - need to log on and cancel my Virgin Mobile internet service.
10:37 a.m. - OK, I *think* I've done everything correctly and won't be charged anymore billing cycles and the current one should end (and not be recharged) on 3/3/2012.

10:38 a.m. - Next on the hit list is to cancel my Charter Internet & cable services. This will help things out a lot.
impressed by Charter - disco was easy and people nice - modem has already been returned. Small move but still saves about $1,000 per year :)

3:48 p.m. - Got distracted by some calls - need to get moving in other areas of my life.

Tri-10, Wk08? - Day ???, Monday, Feb 28 2012

It's actually Tuesday,Feb29th but, I no longer have any classes left at Logan to take on a Tuesday since the Tri-10 class I had (Billing & Documentation) only last 6 weeks and is now over.

I had a really nice weekend of NBS Board Reviews. The instructor, Dr. James is pretty darn impressive. To maintain the high level of energy, enthusiasm and caring he exudes for a solid 8 hours each day is quite a feat. The teacher we had for Billing & Documentation was similar. It's hard to imagine a class like B&D to be overly interesting based on the name of the class but, Dr. Mario did a very good job.

It's hard to keep track of everything in the works. I've got some extra weekend post grad classes I'm taking such as the Internal Health Specialist program and as of this coming weekend, Acupuncture. I never thought I'd be getting involved in acupuncture but, I've seen where it is recognized as a viable treatment by the AMA - I think that was from PubMed and, it's basis seems similar to chiropractic.

Senior Research Project -
Loomis, Internal Health Specialist -
Acupuncture -
Competency Boards -
Part III National Boards -
Advanced Basic -
Differential Diagnosis (ddx) -
Office Management -
Clinic -
Marketing

Financial - Domestic task (cleaning, laundry, dishes...) -

Tri-10, Wk07? - Day ???, Friday, Feb 24, 2012

I'm doing my research project on The Neuroplasticity of Happiness and the following paragraph is what I submitted for approval. (you're only allowed one paragraph)

When considering happiness, is there only so much of an aggregate total of happiness vs. despair, at any given time, such that the proliferation of one will necessarily diminish the influence of the other? In the realm of mathematics this type of situation is known as a Zero Sum Game. Neuroplasticity deals with the brains ability to change and adapt according to its circumstances and given a finite amount of brain tissue to work with then the zero sum game theory may be plausibly adapted to the neuroplasticity of happiness concept. This paper will explore that notion and consider concepts such as an individual's capacity for happiness at any given time, the duality of polar spectrum opposite emotions co-existing or merely fluctuating and if there are emotional thresholds that must be breached in order to experience any given emotion in the first place, much like the way some theories explain how people perceive pain.

other than that I was just trying to get a grasp of what the next few days hold. Lots to do :)

Feb 24, Friday - SRP concept submitted for approval
Feb 25, Saturday - NBS
Feb 26, Sunday - NBS
Feb 27, Monday - LBT IV Midterm due

working on -
SRP, concept submitted for approval
Office Management - need to chat w/ Dr. H?
Competency Boards - 2 down, 4 to go this tri - rest on 3rd day of next semester

need to do -
get hold of Dr. W, get something lined up for clinic

Tri-10, Wk07? - Day ???, Thursday Feb 23, 2012

Looks like it's been exactly 1 month since my last post. I'm going to have to try and post more to maybe help with my focus.

Tri-10, Wk03 - Day ???, Monday January 23rd, 2012

It will take some catching up to figure out what day we're on right now since it's been so long since my last blog (11/8/11) I've had some request from others who have read my blog prior to becoming chiropractic students themselves, some are at Logan and other's are elsewhere across the country. There's also been a few local request to get back to blogging. Some have said it's inspirational but, I'm not quite sure how.

My current favorite class is Differential Diagnosis which is taught by Dr. Kettner. We've been going over chronic pain and it is a fascinating subject. The most recent research would indicate that a main culprit in the chronic pain syndrome is not so much by the stimulus of pain but rather by a lack of inhibition of that pain. A part of the anatomical basis for the inhibition of pain would have to do with descending inhibitory pathways from the brain.

What's really fascinating is something new I learned today called Nocebo - this is the counterpart to the much more well known "Placebo" which most people have heard of with reference to the Placebo effect, when a patient may be given something like a sugar pill but upon believing it is something beneficial will manifest positive outcomes as a result of their beliefs.
Nocebo is the opposite of the Placebo effect - this is based upon a patients pessimistic attitude or even a lack of trust or understanding and can result in increased pain.
But - there are real chemicals at work and real pathways in the Central Nervous System (CNS) which conduct and manifest these beliefs.
On one hand we may have descending inhibitory pathways but those pathways may also be descending fascilitating pathways.
with an emphasis on fascilitation, we may have a lack of inhibition. Substances associated with pain would be on the order of NMDA or Substance P while those substances which help inhibit pain would be things like enkephalins and endorphins.

I've left and gone off on a tangent - I'm reading about GABA-A alpha 2 receptors and their contribution to binge drinking and their association with a persons vulnerability to engage in binge drinking.

from an article in PNAS - Neuroscience, received for review January 6, 2011 we read that Binge drinking was inhibited by GABAa alpha 1 siRNA vactor infused into the ventral pallidum, unrelated to TLR4....

The data indicate that GABA a alpha2-regulated TLR4 expression in the CeA contributes to binge drinking and may be a key early neuroadaptation in excessive drinking...

That GABA is what we've talked about earlier in this blog, I believe it's Gamma Amino butyric Acid.
The TLR4 is Toll-like receptor 4.
CeA is the Central Nucleus of the Amygdala
siRNA is small interfering RNA

The earlier reference to the amygdala is how I got on this tangent to begin with...not sure if I mentioned it specifically before but it's one of the pieces when talking about pain processing pathways.

Tri-9, Wk10 - Day 569, Tuesday 11/8/11

started this blog last night (tuesday) I was chatting with an old high school class mate - we're putting together a night out for another high school friend who has terminal brain cancer

and the friend i was talking with is dealing with neurological issues of her own.

then I wake this morning to find another in our group has passed away - no older then me and died of a heart attack

damn - gotta get to school.. heart disease - even for women it leaves things like breast cancer in the dust as far as morbidity is concerned.

RIP Thomas.

Tri-9, Wk10 Catch-up, Days R,F, M,T,W,R,F, M - Days 561 to 568

Tri-9:

Week 8

Thur - 10/27, Day 561

Fri - 10/28, Day 562

Week 9

Mon - 10/31, Day 563

Tue - 11/1, Day 564

Wed - 11/2, Day 565

Thur - 11/3, Day 566

Fri - 11/4, Day 567

Week 10

Mon - 11/7, Day 568

There is a lot to say, if I were so inclined but, for now I'm looking over what needs to be done this week for my classes. Tomorrow is Clinical Nutrition and Clinical Psychology - 2 hours of each.

Clinical Nutrition - Week 10 - Covering nutritional and dietary management of functional endocrine disorders, metabolic syndrome and carbohydrate handling w/ the following reading assignments;

Female Complaints

1. Cervical Dysplasia - pgs 152-160
2. Fibrocystic Breast Disease - 249-254
3. Menopause - 476-491
4. Menorrhagia - 492-501
5. Nausea & Vomiting of pregnancy (perhaps that should say "due to" instead of "of") - 533-537
6. Pelvic Inflammatory disease - 605-617
7. Premenstrual Syndrome - 650-663
8. Hormonal Balancing with nutrition - haven't found yet

Male Complaints

1. Benign prostatic hyperplasia (BPH) - 112-118

BHP - One of the more interesting parts of the BPH reading was self learning Rx abbreviations. The abbreviations are from Latin and are as follows

• q.d. = quaque die = once a day
• b.i.d. = bis in die = twice a day
• t.i.d. = ter in die = three times a day
• q.i.d. = qaurter in die = four times a day
• p.o. = per os = by mouth - I remembered this one from pharmacology class
• gt = gutta = drop - this one I ran across last night when studying a specific type of psoriatic arthritis called Guttate Psoriasis where the skin produces small, red & scaly teardrop-shaped spots.

Cervical Dysplasia - more acronyms... the ones below refer to possible results from an abnormal Pap smear.

• ASC = atypial squamous cells
• ASC-US = ASC with "Uncertain significance" (some of your cervical cells are abnormal but, we don't really know why)
• ASC-H = ASC with possible HSIL which, begs the question, what's HSIL stand for...
• HSIL or HGSIL = high-grade squamous intraepithelial lesion. high-grade means the cells are very different
• AGC = atypical glandular cells. Glandular cells are cells that produce mucus and are located in the cervix or uterus. Again, this means that some of the glandular cells are not normal and we don't really know why.
• LSIL or LGSIL = low-grade squamous intraepithelial lesions. Here, low-grade means early changes in the size and shape of the cells.

Fibrocystic Breast Disease -

• excisional biopsy = removing all or part of abnormal tissue for examination under a miroscope
• needle aspiration biopsy = when a pt sample is removed without preserving histological architecture of the tissue cells.
• fine-needle biopsy = i'm guessing it's similar to the needle aspiration biopsy but with less histological architecture disturbance...

I suppose my focus should be more on the nutritional aspects of these reading assignments since these are for my Clinical Nutrition class. There were some interesting points I highlighted in this chapter. These points are as follows:

- Limiting dietary methylxanthines (coffee, tea, cola, chocolate, caffeinated medicines) improved 97.5% of 45 women who completely abstained and 75% of 28 women who limited consumption

- women having fewer than three bowel movements (BMs) per week have a 4.5-fold greater risk of FBD compared with women having one or more BMs every day.

Menopause - Wow - with regards to things such as hot flashes or any other symptoms ... A study of Mayan Indians showed NONE of those women experiencing any of those symptoms as well as no evidence of osteoporosis despite hormonal patterns identical to postmenopausal women in the United States. Mayan women saw menopause as a positive event, providing acceptance as a respected elder as well as relief from childbearing

As such, we could say the cultural view of menopause is directly related to symptoms of menopause. If the cultural view is negative, symptoms are common; if menopause is viewed in a positive light, symptoms are less frequent.

Menorrhagia - general def - excessive menstrual bleeding (blood loss > 80mL)

this chapter is reminding me of a few things I need to keep straight -

Graves - hyperthyroidism

Hashimoto - hypothyroidism (aka autoimmune thyroiditis)

Cushing's dz - hyperadrenocoricism, too much ACTH (adrenocorticotropic hormone) released by the pituitary

Addison's dz - hypocortisolism or chronic adrenal insufficiency or hypoadrenalism

• DUB - dysfunctional uterine bleeding
• Metrorrhagia - spotting, uterine bleeding at irregular intervals, esp btw expected periods.
• menometrorrhagia - excessive and prolonged uterine bleeding occuring at irregular, frequent intervals.
• polymenorrhea - menstrual periods that are abnormally frequent, say w/ intervals of 21 days or fewer.
• CEE - conjugated equine estrogens

Nausea and Vomiting of Pregnancy (NVP) -

• Hyperemesis gravidarum (HG) = extreme, persistent nausea & vomiting during pregnancy that may lead to dehydration.
• .

This is interesting. HG, postpartum depression and lactation failure are linked to deficiencies of zinc, magnesium, vitamin B6 and essential fatty acids.

Pelvic Inflammatory Disease -

• dyspareunia - painful intercourse (part of dx summary)
• adnexal (L. plural of adnexus) - accessory or adjoining anatomical parts as ovaries and oviducts in relation to the uterus.
• Porphyrias - a buildup of porphrins in the body. porphrins are a heme precursor in the porphyrogenic pathway and porphrins are toxic to tissue in high concentrations.

Premenstrual Syndrome (PMS) -

• PMDD - Premenstrual dysphoric disorder
• Xenoestrogens - environmental estrogens

Dietary Considerations - Guy Abraham, MD, stated that compared with symptom-free women, PMS patients consume:

• 62% more refined carbohydrates
• 275% more refined sugar
• 79% more dairy products
• 78% more sodium
• 53% less iron
• 77% less manganese

Primary Causes of Premenstrual Syndrome -

• estrogen excess
• progesterone deficiency
• elevated prolactin levels
• hypothyroidism
• stress, endogenous opioid deficiency and adrenal dysfunction
• depression
• nutritional abnormalities
• macronutrient disturbances or exesses
• micronutrient deficiency

Physiologic Effects of an Increased Estrogen to Progesterone Ratio

• impaired liver function
• reduced manufacture of serotonin
• decreased action of vitamin B6
• increased aldosterone secretion
• increased prolactin secretion.

Hormonal balancing with nutrition -

Hmmm - it's after 3 a.m. and I just finished the reading assignments for Clinical Nutrition ...almost to the point where I'd be better off just staying awake and knocking out the psych reading...