Thursday, July 29, 2010

Tri-5, Wk12, Days 319 & 320 - Wed & Thur

The man I mentioned in the last post was born around May, 1971. The xrays we saw (and saw again today) were taken on 7/24/73 and again on 8/24/74.
The man's first name is Breen and I'm not sure about putting his last name down in this blog but, if I ever ran across that anomaly again I think I would refer to it using his full name.

In a way, this whole scenario reminds me of the dark ages when most people would have been better off if they were left alone instead of having doctors try whatever they happened to know at the time. For the most part, I'm certain all doctors have their patients best interest at heart and want to do what's best for the patient.

I kind of spend more time in though and pensive reflection with this topic and the articulation doesn't seem to flow as freely as with some other blog topics.
Breen was less than two years old when this surgery was performed and it pretty much destroyed his life. I think of the anguish his parents must have had to endure and perhaps still are. I think of the doctors who performed the surgery. I think about the fact that we can only use the tools at our disposal. For an MD, that pretty much means drugs and/or surgery. For a chiro we have our adjustments.

I think one thing a lot of people may not realize is that about 90% of the education I've had at Logan is basically the same as you would find in a medical school. I've got 11 classes this semester - 33 hours and only two of those 11 classes involve any kind of adjusting or what the general public would think a chiropractor does while in chiro school.
Our first semester, with 27 hours of classes only had one chiro type class worth 2 credit hours....just checked, my mistake, it was worth 4 hours or approximately 15% of our classes.

Trimester 2 was 28 hours with one 2 hour adjusting class, the beginning of Diversified adjusting or 7% of our class hours.

Of course, we also have philosophy classes which get into the basis, justification and rationale for chiropractic adjustments.

Tri-3 is 6 hours per week of adjusting (more Diversified and Basic) making up about 18% of our 34 hours per week of classes.

Dr. Christy teaches philosophy and the Cardio Dx class I have this trimester. He's very enthusiastic about chiropractic and generally comes armed with a great deal of published peer reviewed literature to lend credence to his teaching.

An interesting article he shared today was titled Increased parasympathetic tone as the cause of Asthma (2009)
Among other things, our parasympathetic nerves can slow down the heart or constrict the smooth muscles in the lungs and increase mucus production. What's nice is that these articles are done by MD's

In fact, a great deal of what he shows us harps around the same theme, basically that of an excited autonomic nervous system and it seems that medical science is starting to catch up with the theories which have sustained chiropractic for so very long.

Dr. Christy also mentioned another type of nervous system in our bodies know as NANC which stands for non-adrenergic and non-cholinergic which uses substance P as it's neurotransmitter. Adrenergic type reactions are those which consist of substances such as epinephrine and dopamine while acetocholine would be an example of a cholinergic substance. Adrenergic refers to the sympathetic nervous system while cholinergic refers to the parasympathetic nervous system.

As a quick review, Sympathetics relate to Fight or Flight
while Parasympathetics relate to wine & dine (or poop & relax)

NANC is new. I found an article online from around 2001 refering to this nervous system but the neurotransmitters weren't known at that time. Apparently, that neurotransmitter has been found to be Substance-P.

I'd have to dig into a database like Pub-Med for peer reviewed research into this for the best data available but, for purposes of this blog and ....since I do have a test tomorrow to study for, we'll just rely on class notes :)

Substance-P and norepinephrine seem to be big players in the realm of inflammation. In my head I have Sub-P related to pain and norepinephrine as a basic substance delivered via the sympathetics (sweat glands are an exception in the sympathetics since they have an acetylcholine substance used to stimulate sweat production)

Dr. Sanders from Lab Dx made some interesting points today regarding normal values and testing. If we gave a single test to 100 healthy individuals then 5 would come up with abnormal results. The definition for "normal" is two standard deviations from the mean when considering healthy individuals. Two standard deviations encompass 95% of the population. So, one test given to 100 people would produce 5 abnormal test results.

The notion gets more interesting though when a battery of test are run. For our case studies we'll consider a good 40 or so test results which means a lot of different people could be scoring abnormal on different test and of the 100 people we test, we could end up with 80 or even all 100 people showing abnormalities in their test results - And, this is from a group of people who are already considered to be healthy!

I guess that's where a doctor comes in handy and can use test as a means of confirming diagnosis.

Tomorrow's big test is in Physical Dx. For Tri-5, it's the 2nd most failed class (after Diagnostic Imaging). Eyes, Ears & Throat seem to be the biggest topics to know for tomorrow's test so I'll try to get some bonus miles out of this blog by listing some conditions we need to be aware of.

Some causes for Red Eye:
Conjunctivitis, Subconjunctival Hemorrhage, Corneal injury of infection, Acute Iritis and Glaucoma.

Abnormal Inspection Findings of the Eye:
1. Ptosis - drooping of the upper eyelid
2. Entropion - an inward turning of the lid
3. Ectropion - an outward turning of the lid
4. Exophthalmos - bulging eyes (often as a result of Grave's dz or hyerthyroidism)
5. Pinguecula - a harmless yellowish triangular nodule seen in the white of the eye ....I'm still not sure how to pronounce that word ....
6. Episcleritis - a localized ocular redness from inflammation of the episcleral vessels.
7. Sty - a painful tender red infection in a gland at the margin of the eyelid.
8. Chalazion - a subacute nontender and usually painless nodule involving a meibomian gland.
9. Xanthelasma - a slightly raised, yellowish, well-circumscribed plaques that appear along the nasal portions of one or both eyelids. This may accompany lipid disorders.
10. Inflammation - a swelling btw the lower eyelid and nose (either acute or chronic)
11. Corneal Arcus - a thin grayish white arc or circle not quite at the edge of the cornea.
12. Corneal Scar - a superficial grayish white opacity in the cornea secondary to an old injury or to inflammation - not to be confused w/ the opaque lens of a cataract.
13. Pterygium - a triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea.
14. Cataracts. Opacities of the lenses visible through the pupil.

Tongue stuff:
Geographic tongue -
Hairy Tongue - a benign condition that may follow antibiotic therapy
Fissured Tongue - aka scrotal tongue
Smooth Tongue - aka Atrophic Glossitis
Candidiasis - a white coating of the tongue from Candida infection
Hairy Leukoplakia ...often seen w/ HIV & AIDS patients.
Varicose Veins - found under the tongue with age - no clinical significance
Aphthous Ulcer - aka Canker sore
Mucous Patch of Syphilis .....

speaking of syphilis - this is a really crappy thing for a newborn to get and, from what I recall, preventable via proper medical attention. Hutchinson's teeth are a characteristic of congenital syphilis. Basically, instead of the ends of the teeth being straight across, they're notched.

I guess it bothers me when kids aren't given a chance and have to start out life needlessly shortchanged due to stupidity.

I better get back to studying. I laid down once and had an alarm set for 11 p.m. but wasn't able to fall asleep in spite of being dead tired. The sleep has been kind of wacko lately - waking up from 1 to 3 a.m. like I did yesterday or oversleeping, often not falling asleep when I ideally should. Only three more weeks though - three weeks from today and Tri-5 will be over.

Also - we only have around 18 exams between now and the end of the semester - not too bad.

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