I'm not sure why I wasn't blogging the last few days. If I'm not blogging literally then I seem to be blogging mentally. We learn so many interesting things and since I live alone and so far from school this is about the only medium I have with which to share this aspect of my life. This past weekend was very productive ...hmmm, looks like I mentioned that in my last blog.
I did notice our teacher wrote the chapter on Infection (and a few others) in a Book I've been checking out of the library called Clinical Imaging. I thought that was pretty cool and figure it's probably a good source to reference for test questions. I've been debating on buying the book for a couple semesters now and finally bit the bullet and ordered it online from Barnes & Noble.
It's almost hard for me to comprehend how much has been spent on books this semester but I'd have to say it's well over $2,000 at this point. Even online, the best price I could find was still over $200.
Earlier this week, I picked up yet another book for Physical Therapy (PT) called Clinical Orthopaedic Rehabilitation. I've noticed most of our books now contain the word "Clinical" in them, maybe that's part of what makes them all so expensive. I was able to find this book online for $88 plus tax but there was no guarantee I'd get it before December 8th which is a little late so...I bit the bullet again and forked out another $125 at the school bookstore. That purchase kind of left me with a bit of an ill feeling, moreso than the more expensive Clinical Imaging book but, maybe that's because this purchase wasn't as thought out, just something I needed for the class.
I got great rates on five other books I bought this week! Maybe less than $60 for the whole lot! :)
Two of those books are supplemental books for my Physical Diagnosis class and I've had both checked out from the library since the beginning of the semester but, other people wanted the books also so I had to return them. Still, the pocket sized Bates companion book I was able to pick up for only $5!!! and I got a brand new Bates' Guide to Physical Examination & History Taking with CD ROM for only $25.
The remaining three books I bought all deal with Neurology, two are kind of fun reading which include The Scientific American Brave New Brain and Cerebrum 2010. The last one is a specialized technique that a classmate gave a talk on this past Tuesday. Unfortunately, it coincided with my Diagnostic Imaging Tutoring so I had to miss it but did get a chance to talk with her about it later that day. The techniques is known by it's acronym, B.E.S.T which stands for Bio-Energetic Synchronization Technique.
The originator of BEST is Dr. M.T. Morter Jr and a past president of Logan. The premise of his system is rather interesting. Wait a minute ...I don't actually know the premise. It would be more correct to say that I am interested in learning more about this system based on the little I've heard and read thus far, hence, the additional books. The book, Dynamic Health is written by Morter so I'll have to get back to you once I've read it. What I've heard is that our thoughts have an influence on our health. That seems reasonable enough. I'm hoping these new books will aid in my understanding. I've already got the high powered medical text so, we'll see how well these other books gel.
We've got 12 more days until our 3rd Physical Diagnosis exam. This next one will be over the abdomen, hernias and the rectum. We took a vote on whether to have the exam next Friday or the following Monday. 30 people voted for next Friday and 35 voted for the following Monday. I was in the following Monday category.
We also have an EENT exam next Thursday. I *need* to get to the research lab and sign up for a couple studies. Our teacher, Dr. DeGeer, is giving us 3 extra credit points per class for two studies. I've already got 2 extra credit points from our last two quizzes so that's a total of 5 points per class which means a legitimate grade of a B+ could turn into an A! I need more of those :) Which reminds me - on the last Pediatrics quiz I got back the teacher wrote "Totally Stunning, ! Scott" at the top of my paper. That's even better than a smiley face, in my opinion. :)
Geez, I've got a lot to learn. To get a better grade on Exam 3 of Physical Diagnosis II, tonight I'm going to learn Abdominal Signs Associated with Common Abnormalities.
These signs include
Sign - What it is - What it indicates
- Blumberg - rebound tenderness - peritoneal irritation & appendicitis
- Cullen - Ecchymosis around ummbilicus - hemoperitoneium; pancreatitis; ectopic pregnancy
- Dance - Absence of bowel sounds in the right lower quadrant - intussusception
- Grey Turner - ecchymosis of flanks - hemoperitoneum; pancreatitis
- Kehr - abdominal pain radiating to left shoulder - spleen rupture; renal calculi; ectopic pregnancy
- McBurney - rebound tenderness & sharp pain when McBurney point is palpated - appendicitis
- Murphy - abrupt cessation of inspiration on palpation of gallbladder - cholecystitis
- Rovsing - Right lower quadrant pain intensified by left lower quadrant abdominal palpation - peritoneal irritation; appendicitis
This is cool, we covered Blumberg, Murphy and Rovsing signs in our Physical Diagnosis lab today and I listed to my phys dx class lecture on the way to school and learned (heard) about Cullen and Grey Turner (over and over and over again)
Oh, the other thing I pounded into my head on the way to school was Caput Medusa which are veins showing around the belly button due to increased venous pressure due to hepatic (liver) issues.
One other thing - today in Dx Imaging we covered a disturbing case involving a 73 year old female. Metaphorically speaking, I think the surgeon that operated on this lady should be shot.
Take a look at this vertebrae. We have 24 of them which stack on top of each other to form our spinal column. Take a look at the overhead view of the vertebrae (the one on the left). Do you see that hole in the vertebrae? That's what our spinal cord runs through. Those pieces of the spine that are labeled (spinous process, Lamina, Transverse Process and Pedicle) surround and help protect the spinal cord. Our 73 year old female patient was experiencing back pain. The surgeon determined there was spinal stenosis - basically, the opening for the spine to run through wasn't big enough for the cord to run through, there was pressure on the cord so his solution was to CUT OUT AND REMOVE all the posterior pieces of the vertebrae!!! He removed everything but the body of the vertebrae and he removed those parts of the vertebrae from no less than 4 levels of vertebrae. Basically, her entire lower back had those pieces cut out - Sawed out - .... This whole procedure and case swam around in my head for hours and hours after that section of our Dx Imag lecture today. The number of muscles and ligaments that had to have been removed in such an operation is mind boggling. Then I'm thinking - Where the heck does the psoas muscle originate from now???! If memory serves, that muscle originates from the transverse process of the lumbar vertebrae then, on it's way down to the proximal inner head of the femur, joins with the illiacus muscle but ...if there are no transverse process?!?!
What kind of stability does this patient now have in their lower back!?
Oh yeah - now I remember the supposed reason for the stenosis or narrowing of the spinal canal - "disc herniation" ....are you kidding me? I saw the MRIs of this patient. She actually had gorgeous disc space and at best, maybe some bulging of the disc. It just sucks. This case elicited quite a bit of emotion. When I see 73 year old female, I'm thinking "Grandma" and that was no way to treat grandma.
What ended up happening ....this patient was having trouble getting hold of the physician who performed the surgery so she want back to the MRI doctors to ask for help. When the radiologist finally looked at the films he described as what the surgeon did to his lady as "criminal", so much so, that the surgeon did end up losing his medical license.
It just so happened that the radiologist MD is friends with our Dx Imaging teacher and in the hopes of helping to prevent any further tragedies of this nature, the radiologist ended up sharing the MRI film to be used in our classes at Logan.
If I understand this correctly, it seems a contributing factor to this fiasco was the fact that the lady had very good medical coverage which was able to cover the cost of the six digit surgery.
It's just sad because the remaining days of this ladies life was altered for the worse. I obviously do not mean any disrespect towards surgeons. This was just a tough case to swallow.
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