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...

Tri-9, Week 8 Catch-up, Days 558, 559, 560, Mon Tue Wed, 10/24, 25, 26th

Week 8

Mon - 10/24, Day 558

Tue - 10/25, Day 559

Wed - 10/26, Day 560

In the midst of midterms right now. got more to do then can fit in the front of my brain. Clinical Psychology midterm is today.

Tri-9, Wk7 Day 557 - Friday - 10/21/11

Tri-9

Week 6

10-12, Wed - field day - no classes

10-13, Thur - Day 551

10-14, Fri - Day 552

Week 7

10-17, Mon - Day 553

10-18, Tue - Day 554

10-19, Wed - Day 555

10-20, Thur - Day 556

10-21, Fri - Day 557

This Trimester started out with concerns for a an old high school classmate of mine who had a sick daughter. ...mulling

anyway, my friends 27 year old daughter died of a heart attack after the first week of the tri

This same friend had a son who she had been fighting to get through high school and she was successful at that and last night a friend of her son's hung himself and is also now dead.

I'm getting more and more friends on facebook that are no longer alive. it's a curious situation.

Imagine an article written with the title "What if Jesus had Facebook?"

Facebook is kind of a life diary like non other in existence. Imagine being able to pull up a facebook page of Benjamin Franklin or George Washington - eventually we may get to that point.

The kid who hung himself had been kicked out of his house while still in high school. My high school friend and their family had taken him in a number of times while he tried to find a place to live.

This makes me think that no matter how crappy of a parent you might be, if you are at least there for your kids that could literally be the difference between life and death. It certainly seems that way for this kid.

I looked over his facebook page. He graduated in 2011 - he left behind 4 brothers and a sister. oh, and his best friend who was my friends son.

I'm working on a couple of CBI's, Northwestern is still in my head and after 5 weeks in the Lose to Win STL Challenge I'm down 38.2 pounds - better then a pound a day and walked a little over 100 miles in those past 5 weeks.

i also dropped clinic this past week.

it is what it is...

Tri-9, Wk6 Day 550 - Tuesday 10/11/11

Tri-9 Monday - Oct 3, Wk 5, Day 544

10-4, Tue - Day 545

10-5, Wed - Day 546

10-6, Thur - Day 547

10-7, Fri - Day 548

Tri-9, Week 6

10-10, Monday - Day 549

10-22, Tuesday - Day 550

I'm not sure what blogs I'll be keeping up with from here on out. It's very difficult to care anymore. Logan has a way of doing that to you.

I heard a comment from Dr. Christy the other day who said he likes teaching the younger Trimester students because they're happier. That's a pretty accurate assessment.

Logan may have a lot of things going for it but, generally speaking, instilling enthusiasm in it's students for chiropractic is definitely not one of them.

The one thing they do engender in the last few trimesters is an overwhelming desire to get the hell out and be finished with Logan once and for all.

We've still got some great teachers in the classroom and I don't mind heavy work loads but, I'd have to classify my own exposure to the program, especially in these last few tri's as abusive and, as far as clinic goes, I'm tired of being treated like shit.

Tri-9 Wk5 Day 544 - Monday, Homage to Dr. Sanders

First, to pay my respects to a Great teacher who passed away this past Friday, Dr. Gary Sanders

Mourning the loss of Dr. Gary Sanders, PhD at Logan University. Thanks for sharing your knowledge, contribution to science and strong commitment to helping students like myself. Dr. Sanders has published research in JNMS: The Journal of the Neuromusculoskeletal System, JMPT: Journal of Manipulative and Physiological Therapeutics, Chiropractic Technique, The New England Journal of Medicine, the Journal of Clinical and Laboratory Immunology, and others.

Dr. Sanders is on the right in the picture below. As a Pathologist Dr. Sanders once comment that they (pathologist) were often thought of as the Doctor's Dr. Huge loss. I used to talk with him on a pretty regular basis, at least 4 or 5 times a week. His funeral and visitation is tomorrow from noon to 1. I've got clinic. :(

I'm getting stuck here. Here is a public link to my Logan Family album on facebook. http://www.facebook.com/media/set/?set=a.1820711920619.106170.1324821250&l=408738468b&type=1

the 41st picture is of Dr. Sanders along w/ my homage to him.

What else is going on....

I did get a very nice comment on my last post from a DO student. He sent me a message that he thought I was an instructor at a med school! That was nice to hear. :)

I've really gotta get more videos up ...especially while I still remember a few things. I know I wanted to do a video on the malate shuffle back from my biochemistry days but I don't quite remember it enough right now to knock out a video. I still retain the gist of that concept :)

Week 2 results came out today in the 1,000 person Lose to Win weight loss contest being held here in St Louis and I moved from 9th to 3rd place which is kinda cool. Online results are here - http://www.ssmhealth.com/depaul/losetowinstl/pages/results.aspx

The people who were in the top two spots last week aren't even in the top 10 anymore and if either of them would have just maintained their weight loss they would have still been in the top 10 so ....logic dictates that those two had to have gained weight.

Test coming up Friday - another dozen or so classes to look over.

two hours of clinical nutrition and two hours of clinical psychology tomorrow - clinic attire is in the washer & dryer right now -

Got another 6 miles in tonight after school - just walking but, it was on a new path which was nice. Fri, Sat & Sun was pretty much a bust - fell asleep early friday after i got home from clinic and had class all day Sat followed quickly by a super nice dinner then out to some club in St. Louis that was supposed to be all swanky & stuff. Didn't seem like anything all that amazing but, maybe that's just my age talking. Club stuff was quickly followed by Sunday class at Logan.... (yeah, it was a long Sat night...) and getting done with my class on Sunday was quickly followed by more much needed sleep but, I did wake up for an hour around 9 p.m. Sun night then fell asleep until my classes today.

Tri-9 Wk4 Days 540, 541, 542, 543 - Tue, Wed, Thur, Fri

trying to remember what the heck i did this week regarding school....

I don't remember the classes so much but I record my classes and listen to them while I'm out walking & jogging at the park. I remember my park lectures :)

I'm liking Advanced biomechanics. We've got a couple younger guys teaching that class, I think they've been out of Logan for about 10 years now. They have some supurlative analogies they give in class.

Rheumatology is taught by Dr. Guebert who is a DACBR and that's always a positive thing. DACBR lectures tend to be fraught with useful information, plenty of meat to those classes as opposed to some other classes where a teacher may be groping to trying and find enough material to talk about to fill their hour of class time which makes me wonder why such a teacher would skip over reading the slides and flipping through things so fast. I guess if I ever teach a class I'll have to remember that.

I did some pretty good work for Nutrition and our Capstone class. Still getting into the groove and handed in a substandard piece of work in week two for Capstone but, had a nice 4 page write up for our week 3 assignment. Also had four pages written up for Nutrition.

The amazing thing about having days off from clinic is that after my shift tonight, i'll actually have 3 days off from clinic!!! YeeHaw!

I do have my specialized technique class this weekend but that still doesn't take away from my day off on Monday! :)

I sent my brother an email asking about the whole CBI thing and if he might be able to inquire at one of his EPOC meetings if anyone was interested in a free intern :)

My training has been going well and it's one thing I can totally count on because it's simply up to me to make happen. My involvement with the Lose to Win competition has been invaluable. There isn't anything too difficult about the working out and dropping weight, in the past few years I just haven't had much focused awareness of the working out because my attention has been so imbued with school stuff. I'm at 60.1 miles total in the last 2 weeks & 4 days and 20 of those miles have come from the last four days :)

I need to get riding my bike since I signed up for a 50 mile bike ride which is in two weeks and I haven't ridden my bike in at least a year!

Tri-9...Week ????, OK, Wk4, Day 539 - Monday

it's taking me a while to figure this out...

days from week 1

528 - 9/7 - wed

529 - 9/8 - thur ...already got those days logged

530 - 9/9 - Friday

yeah - on 9/10, a friend i went to high school with had a sick daughter and she died this day.

Miranda Bell, only 27 years old. Rest in Peace.

531 - 9/12 - Monday

532 - 9/13 - Tuesday - funeral

533 - 9/14 - Wednesday - Here is the tribute that was done for Miranda via YouTube... might need to have some Kleenex handy for this one... http://www.youtube.com/watch?v=GMD_vXNzPTk&feature=youtu.be took a vacation day from clinic on this day.

### - 9/15 - Thursday - no school so we can study for boards

### - 9/16 - Friday - Physiotherapy Boards - idk - some 160 questions or so about PT stuff. fairly good chance I passed this exam

### - 9/17 - Saturday - Part III National Boards - just another couple hundred questions on diagnosis & other fun stuff like that. not sure about this one, maybe a 50/50 chance of passing it.

### - 9/18 - Sunday - retook Chiropractic Practices of Part II.

If I passed all those test over the weekend then, along with a DC degree, I'll be legal to practice in the state of Illinois. Most states also require Part IV. I don't think I ever counted boards as class days or anything (hence the ###) - not sure...

Week 3

534 - 9/19 - Monday -

535 - 9/20 - Tuesday -

536 - 9/21 - Wednesday -

537 - 9/22 - Thursday -

538 - 9/23 - Friday -

9/24 - Saturday

9/25 - Sunday

Week 4

539 - 9/26 - Monday

I've got days off & away from clinic this trimester - makes a BIG difference!

started hitting the park again to get back into jogging. I think I've got around 45 miles in over the past two weeks.

entered a LoseToWinSTL.com contest consisting of 1,000 people in the St Louis area. For week 1 I took top honors from all the contestants weight in at the Fleet Feet stores and also made the top 10 overall for all contestants.

honestly, i think the only reason I signed up for this current semester was for the student loan money so i could continue to pay my bills.

sort of a bit apathetic towards it all.

Tomorrow is two hours of clinical nutrition, two hours of clinical psychology then four hours of clinic. I'll need to get straight to the park after clinic then home to knock out a Business type assignment due on Wednesday.

I *really* need to find a CBI - Community Based Internship so I can get out of the St. Peters clinic. One of our teachers was telling us today about a former student who was maybe 5 years older than me and ended up having a heart attack at school. HTN & stuff. I can relate.

Tri-9 Wk 1 - Days 528, 529 - Wed & Thur, 9/7, 9/8

I think I have the numbers portion of this blog all caught up. I sort of shut down a few days prior to last semester ending. kind of stayed shut down. and...I don't usually blog between semesters and have far less enthusiasm for school here then when I started.

Let's see... what's going on? I was able to make a deal with my dxi teacher to attend an extra 10 hours worth of radiology conferences in exchange for being able to take the final exam in spite of my absences. I had to give Dr. Kettner the 10 hours regardless of whether I passed his final or not. I thought it was a pretty cool deal. I accepted the deal and did pass the final and the class. kind of impressive when you consider i wasn't in class the last few weeks and took the final cold without any studying.

This is the kind of deal that Dr. K has made with students in the past and I know there was one other student in our class that made the same deal with him. It makes sense since those Rad Conferences are every bit as educational as the classroom atmosphere would be.

But .... the powers to be who make decisions about the school .... and, why is it the people most removed from the classrooms are butting in to things they know less about then the teachers?

anyway - they haven't let Dr K change my grade from an AF (attendance fail) to a passing grade. so...that means I can't officially sign up for my classes, can't get any of the sylabus' or class materials and don't really know what my classes will end up being. Can't get my student loan check either.

As is, I just have to retake Rheumatology which, I had a B or B+ in (depending on how much the extra credit I did helped) due to an AF I got in that class. Rheum is just a two hour class held on Mondays so, the rest of the week I would just take courses with my regular class. It's kind of a nice situation since I get to end taking classes with my original class then get to see all the rest of my classmates who are in the current Tri-8 class.

anyway, essentially we have yet another in a LOOOOONG list of impromptu changes by people who have no actual experience with the current program and have no idea what things are like as is.

Oh well, my primary focus right now has to be for the National Boards, Part III & PT coming up in about a week - next Friday, Sat & Sun. I'll just keep showing up for my classes as best as I can figure them out.

Today's pic will be my second completed painting, it's another guitar and this one is called the Electric Leah. Next painting will be done on Thursday, Sept 22nd. It's going to be Grapes! and it's pretty cool ;)

Tri-8 Wk15 - Days 524, 525, 526, 527 - Mon, Tue, Wed, Thur

Tri-8 Wk15 - Days 524, 525, 526, 527 - Mon, Tue, Wed, Thur

Tri-8 Wk 14, Days 521, 522, 523, 523 - Tue, Wed, Thur, Fri - 8/9, 8/10, 8/11, 8/12

Tri-8 Wk 14, Days 521, 522, 523, 523 - Tue, Wed, Thur, Fri - 8/9, 8/10, 8/11, 8/12

Tri-8 Wk14, Day 520 - Monday, 8/8

Over the weekend I received a letter from Logan stating I had AF'd Dx Imaging. AF stands for Attendance Failure and means I have to take the class over. I didn't make it in time for Rheumatology this morning so I also have AF'd that class as well. I love the trite, arrogant advice that gets tossed my way sometimes such as the brilliant Tx of "you need to get more sleep". No shit Sherlock, I think to myself. As Dr. Kuhn had pointed out in class one time, "it's not as simply as turning a page in a book" which, is pretty much my situation. If any of my unsolicited advisors had any clue what they were talking about they would know there's a bit more to the story and Tx then just "get more sleep".

Varieties of the "Walk in my Shoes" is a is a status post I've seen a lot on Facebook lately and that's kind of what I think when I hear such flippant advise. Try waking up with 30% less oxygen then you went to bed with, see how that feels and how well you can function. Try driving an average of over 650 miles per week for school and spending about as much time sitting in your car as you do in class and try doing all this when you're 45 as opposed to being in your 20s.

...insert a couple hour time gap here...

looks like this gets finished later...

Tri-8 Wk13, Day 519 - Friday, 8/5

I had this day off from clinic, for which I am extremely grateful.

I painted a picture the night before in honor of my new nephew. I called the painting The Wyatt Gibson. I'll toss up a picture of this and keep catching up with my blog entries. :) The painting is acrylic on canvas.

New Baby!

Tri-8 Wk13 Day 518, Thursday 8/4

My brother and his wife had a new baby boy this morning at 7:01 a.m. and named him Wyatt John Dukowitz!

I'll toss up a picture of the lil critter and move on to catch up on my Friday blog ;)

The vacation day that never was ....

Tri-8 Wk14, Day 517, Wed, 8/3

I was hoping to take off tonight so I could more adequatly study for my PT III practical tomorrow but, after a couple members of the "staff" expressed concerns over my vacation request I acquiesced and withdrew the request. Guess what? The patient never showed up anyway. It's sort of an every other type even with that person ...

grrrrrr .... is about all i can say.

so, i will end this tri with more than enough clinic hours and two unused vacation days.

Those vacation days have gone way down.

Based on once a week clinic duty and three days off and a 15 week semester - 3/15 = 0.20 or 20% vacation rate.

at three days a week for 15 weeks with 6 vacation days ... 6/(15x3) = 6/45 = 0.13 or 13%

at 5 days per week for 15 weeks with 6 vacation days... 6/(15x5) = 6/75 = 0.08 or 8%

and ..5 days per week for 15 weeks with 4 vacation days = 4/75 = 0.05 or 5%

so, we slaves have the vacation days cut from 20% to 13% to 8% to 5%

anyway - it was kind of bullshit for me to give in - guess it's my fault but WTF. just give us our f*cking vacation days without any hassle.

whatever.

Tri-8 Wk13, Days 515 & 516, Mon & Tue, 8/1 & 8/2

shit ....

I've got a PT III final practical on Thursday and tried taking tomorrow off so I could study for the class which I've scarcely been to but, after submitting my vacation request I found out I have a patient scheduled ...I didn't actually schedule them, it's something the front desk took care of which is fine ....

As is kind of customary these days, I fell asleep soon after I got home tonight which means, by 5:30 p.m. since I actually got off work at 3:30 today and got up about an hour ago (11:30 p.m.) but, not I'm not exactly sure when I'm going to be able to get enough study time in for this exam on Thursday. Since I just got up I could maybe stay up but once tomorrow starts it won't end until I get home at 8 p.m. which means it will be *really* hard to continue to stay up to study for that exam.

Hell, i could fall back asleep now. Maybe not. I'm just pissed off.

idk- i'm tired - going back to bed - looked over some PT stuff but not really sure exactly what to study ...hence the need for extra time to have any chance of getting through that final.

Tri-8 Wk12, Days 513 & 514, Thur & Fri, 7/28 & 7/29

I survived. Two solid months of mandatory 5 day per week clinic is FINALLY over. Like a lot of people I was saving the gist of my vacation days for finals but it looks like the start of the next semester is our first day of finals for the current semester. I'm not sure I quite understand that because you don't actually move on to the next semester until you've passed all your classes. oh well.

I put in vacation request for 8/5 and 8/12, two Fridays in a row and now that I'm back to a normal clinic schedule that means I'm already off on Thursday and now on Friday and Saturday and Sunday and Monday!!! - Five Days in a ROW! YeeHaw!

I'm not exactly sure what's going on in school.

I really had no solution for effectively dealing w/ the abhorrent schedule I was subjected to over the past couple months. About all I can say is that it's a good thing I don't own a shotgun. I have been learning quite a bit but, not necessarily anything specific to any current classes. This reminds me of the special class I was put in during grade school where us higher motivated types of students wrote out on a contract what we wanted to work on during the week.

One interesting thing I studies was the primary and secondary ossification centers in the metacarpals and the phalanges. Both metacarpals and phalanges have primary ossification centers centrally located along their shafts but the phalanges have secondary ossification centers proximally, at their bases while the metacarpals have their secondary ossification center distally located. BUT WAIT - only metacarpals 2, 3, 4 and 5 have secondary ossification distally and metacarpal #1 (the one attached to the thumb) has a PROXIMAL secondary ossification center which means in terms of ossification the first metacarpal is more like a phalanx. Makes me wonder if things were misnamed originally... this same phenomenon occurs in the foot.

with the carpal bones, ossification starts at the capitate and kind of spirals around in a counter-clockwise direction but, the age at which these carpals ossify isn't exactly one per year but more like 2-3 months for the first two then age 3,4 and 5 for the 3rd 4th and 5th but, also year five for the 6th and 7th. then the pisiform which is just a nifty little sesamoid bone finally ossifies between the ages of 9 to 12.

I've also been going over some of the neural pathways, specifically w/ the eyes and the various reflexes. Unilateral cranial nerve palsy has also become an interest mainly because it's now clinically relevant and we've got real people involved. Of course ...I'd say about 1/2 the people I'm working with and trying to learn things for aren't even official patients from my clinic but still people that come to me with issues so I do the best I can.

...got severely sidetracked here - oh well, that's it for now :)

Tri-8 Wk12, Days 511 & 512 - Tue & Wed, 7/26 & 7/27

I'M DRIVING LESS THAN 40 MILES TODAY! I'M DRIVING LESS THAN 40 MILES TODAY!

I'M DRIVING LESS THAN 40 MILES TODAY!

I'M DRIVING LESS THAN 40 MILES TODAY!

I'M DRIVING LESS THAN 40 MILES TODAY!

I'M DRIVING LESS THAN 40 MILES TODAY!

I'M DRIVING LESS THAN 40 MILES TODAY!

• I'M DRIVING LESS THAN 40 MILES TODAY!
• I'M DRIVING LESS THAN 40 MILES TODAY!
• I'M DRIVING LESS THAN 40 MILES TODAY!

That's 40 miles TOTAL. I've had enough - quite enough. I'm going to the St Patricks Center in downtown St Louis for my clinic shift today. there's only so many days the 5 a.m. alarm can go off with me waking up as if I've been run over by a truck.

Next week - week 13 will be my first opportunity to get out of this mandatory 5 day per week rat race. I think I summed it up best in an email I had to send one of the teachers whose class I'd already screwed up in when I said, "If everyone in Tri-8 has the same requirements then we should all have the same demands."

Amazingly enough, I got home at 5 p.m. yesterday! It was fantastic. I was also asleep by 5:30

I know Dr. Guebert has talked about his father and the pain that man has been going through. It makes me very sad. I know there has been reference to him maybe "checking out" voluntarily.

I know we've talked about the mortality rate with reflex sympathetic dystrophy and the number one cause of death with that disease being suicide.

I know my pains probably aren't as bad as others but, dropping a third of your O2 saturation levels over night doesn't feel very good either. I've read the mechanism behind it is equivalent to a severe stroke or dying.

I've come to believe that things like a person drinking soda or ingesting Splenda are probably far less detrimental to health then losing the will to live.

I've read about cultures in Africa where capital punishment consisted of ignoring the offending party until they eventually wandered off into the mountains and died.

I never was able to come up with a solution to my situation which would allow me to effectively continue to get up at 5 a.m. every day then go to all my classes then go to clinic every day as well as attend all of my weekend obligations such as Loomis, SOT or Irene Gold board reviews.

I no longer think sleep is the answer but maybe just a beginning of a solution. The weekends I did have off, especially the last weekend when I missed my final SOT classes I was in and out of bed constantly and never up for more than two hours at a time and that still didn't help the exhaustion.

Moving, being healthier and being younger were the only answers I could come up with. The idea of putting my home on the market and moving seemed too huge an endeavor to pull off with all the school demands. Healthier is an option. I know I started training for my St. Peters shift back in Tri-7 and was going to the gym quite often. Of course, at that time, I was only aware of the distance I'd have to be traveling and not the 5 day per week shifts. Younger ...nothing I can do about that and, quite frankly, .....yeah .....what is, is.

I am going back to sleep now. That's pretty much where I live if I'm not in a class or clinic.

Tri-8 Wk12 Day 510 - Monday, 7/25

5 months until Christmas -

maybe 2 weeks or so until I get a new niece or nephew - that will be pretty nice :)

not really much sure about anything else.

Got my last Case Report in today but wasnt able to listen to my 20th case report due to patient duties.

It does seem like week 12 will be my final week of mandatory 5 day per week clinic.

Dr. Hogarth, my clinician, is really pretty good at overseeing the case reports. I've never seen him in a classroom situation but he definitely seems to have a talent for teaching.

The case report I gave tonight didn't have a clear cut resolution due to non-compliance by the patient but, it did involve a pretty serious auto accident and I was really curious what Dr Hogarth had to say about it. He did not disappoint. A class might be good but that could be slow going. Hogarth would probably make a great teacher for that class but I have no idea if he'd want to leave clinic.

My favorite scenario is what a clinic pulled off last Friday by knocking out 16 case reports in a single evening. That's what a fellow intern told me anyway. All I can think is that represents 8 days I could have been off from clinic.

Dr. Guebert had a pretty good class today. We got to see a CT with contrast and it was a really nice picture showing the relationship between a vertebrae, the psoas muscles and the ureters. I think most everyone knew the roundish images on the CT were ureters but seeing the relationship to other structures was pretty cool.

That's about it.

Oh, my radiator went out and I got a letter from the IRS. Car is at the shop to get the radiator fixed and ....i guess the IRS really did want me to file last year even though I didn't work or sell any securities.

Tri-8 Wk11 Days 508, 509 - Thur, Fri 7/21, 7/22

I took a vacation day Friday from clinic and it was the first day since May that I've been able to go straight home from school instead of dealing with clinic. I did take one other vacation day on a Friday but ended up staying at school until 6 p.m. so I could finish up various requirements that I just haven't had time to finish up, most notable my radiology conferences.

Originally, I thought the vacation day would also let me stay up late to study for my derm exam on Friday but I was way too tired to fall asleep. I made good use of my time on Friday - got to have a quick lunch with my parents then got my tires rotated and oil changed at Valvoline. I wasn't able to stay awake much past 5 p.m. and fell asleep. I woke up a bit after midnight and watched some of the horrific tragedy that took place over in Norway where 92 people have now been declared dead due to the messed up actions of one person. I fell back asleep after that and slept until 10 p.m.

There just doesn't seem to be any catching up on sleep anymore. i'm flat out chronically exhausted. I've scarcely anything new to say. I did read a few weeks ago about a very young administrator that was once hired on to the faculty at Harvard University and the one thing he immediately implemented was that if any department head wanted to add anything to their program then they had to take something else away. Kind of reminds me of the PAYGO plan signed by President Bush that forced Clinton to only spend what monies were available or to eliminate existing expenditures to offset any new spending. At least those are the charts I see most often. I'm sure 101 different views and opinions exist but ....I'm no expert in the field ...

I guess I need to get an application in to Northwestern University (NW) I need more information. There may be a CBI or Community Based Internship available which may suit me but, honestly, I don't feel fit to run a cash register at Dairy Queen right now.

I thought the process of becoming a chiropractor at Logan would help me become a better person but it's doing nothing but destroying me. NOBODY should have to drive 4,000 miles in their first 6 weeks of classes - that comes out to over 650 miles a week. The one individual week I checked w/ my car's odometer put me at 718 miles for the week.

In the few trimesters before becoming a Tri-8, the most common comment I heard from upperclassmen was that they wanted to burn down the school. I never gained full insight as to why they were disgruntled but I'm sure part of it had to do with the switch from 1 to 3 days per week mandatory clinic. I also know the valedictorian of the last graduating class made a comment in his speech that his class was about to step across the stage to get their diploma "as long as there were no more graduation requirement changes".

I wonder how students who transferred to Logan were so enthusiastic about chiropractic. I don't remember exactly which college it was but I think one of them lost their accreditation which caused the influx.

I just don't know .... I love my patients and I love being able to actually help make people feel better and help alleviate them of pain & suffering ....

I really can't stand the end game of this DC program at Logan.

I do know that last Friday, one of the clinics was scheduled to knock out 16 Case Reports! 16 in one day!

I know that the person behind scheduling our case reports NEVER had to come in on his day off for a case report. I know out clinician simply backed him up instead of ever once bothering to look into any reason why anybody would be disgruntled about the schedule. I know my name has come up a lot with my clinician (he told me it did) but, I have no idea exactly what was said because he had nothing further to say to me other than my name had come up a lot. who knows.

I detest their newly implemented No Tolerance policy with regards to switching clinics. Seems like they're doing everything under the sun so as not to ever have to deal with any student concerns regardless of the circumstances. I'd like to see those who implement the policy drive 4,000 miles over the next 6 weeks. I dare any of them to try and get through the Tri-8 program under the same circumstances as me.

probably a waste of time to write about any of this. I still have work to do. and, either i'm staying or i'm going.

Recommendation to any students considering chiropractic school .....LOOK AROUND - see what their programs are like - LOOK at the end game - COMPARE - right now, all Logan knows is to add, add, add without having a clue of all the consequences they're having on their students.

Tri-8 Wk11 Days 505, 506, 507 - Mon, Tue, Wed 7/18, 7/19, 7/20

*If* I take a vacation day from clinic tomorrow then I can pull an all-nighter for my derm exam.

I had my transcript sent to Northwestern on Monday and joined an Online Chat with a few students Tuesday night. I know they might start taking grades into consideration when determining their outpatient clinic assignments. I wonder why it never occurs to anybody to take into consideration proximity & preferences.

I keep thinking of Shakespeare and the line that we'd "rather bear those ills we have then to run off to others we do not know"

NW claims to average about 650 adjustments per student and they don't have to go out to find their own patients. It would take a minimum of 5 trimesters to graduate from NW ...that's the kicker part. I'm kind of on the fence. I do like the idea of dropping HCP here at Logan and not having to drive so much. The only way I'm really making it is by missing tons of classes which makes me wonder what the hell I'm paying so much money for.

Tri-8 Wk10 Days 503 & 504 - Thur & Fri - 7/14, 7/15

hard time moving this morning ....

Rheumatology exam is Monday, Case Report is due Monday, Report of Findings for a new patient is due Monday, Final Exam in SOT is due tomorrow (Sunday) and ...I should be in SOT class right now ....

it's still in the a.m. and I'm finally dressed and pretty much ready to go. I'll probably end up at school after the lunch break.

The people at Logan are pretty much great. The instructors are probably among the best of any chiro college in the world. Is it the institution I hate or maybe the DC program. I was at a table with some Tri-9's yesterday and even more changes are being implemented for the first time for them in Tri-10. Something about having to be at school on Fridays ...things have changed so much and I'm not sure exactly how the changes are supposed to make better doctors of anyone.

Tri-10 is kind of the 5 day a week clinic schedule, if needed. I know one guy who did that in order to graduate on time. He got the last adjustment in he needed just 4 days before graduation!

oh hell, ...things could certainly be worse. I could have lost my spouse and job in the same week then be forced to move as my neighbor is dealing with right now. Doesn't really make my current situation any easier to deal with ...just perspective.

Of course, I lost a good friend in that process as well. Probably the one human being I spent more time talking with than anyone else. I still have my dog ...she's just not much of a conversationalist.

Being at the most distal clinic possible is one thing but, having to be there five days a week is quite another.

I need to have my Case Report done before Monday - have to prep for ROF on Monday before patient arrives at 4 p.m. I give my case report at 3.

RADIOLOGY! damn! how could I have forgotten about that! ...those reports are due by 9 a.m. Monday ...

Gezzus ....let's get this straight ...

SOT - Classes Sat

SOT - Classes & Final Exam Sunday

Radiology - 10 Case Reports due Monday morning

Clinic - ROF etc., with new patient at 4

Clinic - Case Report due at 3

Rheumatology Midterm Monday morning

that's gotta be close to it ...just mix in over 200 miles of driving and you have my current life for the next couple days.

Tri-8 Wk10 Day 502 - Wednesday

Ridiculous is a word I often hear used to describe the later trimesters at Logan. I use that word too, along with the word INSANE.

I'm looking at other chiropractic colleges and notice that up at Northwestern University their Tri-8 schedule consist of 18 hours worth of classes - Those classes meet 9 hours a week on two days per week. When I look at Parker college I don't see any classes in 8, 9 or 10 - just Internship.

When I look at my classes for Tri-8, I'm seeing 38 hours of classes - 5 days per week and sometimes on the weekend. I see clinic 5 days a week, I see my 650+ miles I drive per week and I just have to wonder why.

ok - i've got an email out to Northwestern - just looking into the possibility of transferring. If I need to sell my home and move in order to make it through the program I might as well consider all possibilities of where to finish up my education.

Gotta run ...school beckons.

Tri-8 Wk10 Day 501 - Tuesday

Today we had a presentation by the NCMIC which is an agency which provides malpractice insurance for a majority of chiropractors. They have a pretty cool website called startingintopractice.com that looks like it could be pretty useful someday. That presentation lasted from 8 to 11 then I had to head to clinic for a 12 o'clock appt.

I have another new patient on the books for tomorrow. Not sure exactly what time but I'll figure it out.

For as sick as I felt yesterday it was GREAT to be able to come straight home after classes. It was nice to come home today and not want to look up guillotine's on eBay. ;)

Still blogging from my iPad. Have a case report due Thursday so I better get a template together to get that taken care of ASAP.

I think after next Thursday... At the end of week 11 I will no longer have a mandatory 5 day per week clinic shift and will just have to try and get my patients in when I'm actually scheduled to be in clinic. Even if I can just get one day a week away from clinic then I might have enough time to pull out the senior project that's due this Tri.

Tri-8 Wk10 Day 500 - Monday - 7/11/11

Laptop is down, won't recharge. Hoping it's a bad plug or, at worst, needing a new battery. Today was Bootcamp from 1-5:30 pm which replaced our clinic shifts. We just found out that tomorrow we have meetings with one of the main insurance companies for chiropractic which is supposed to be mandatory and last from 8 to 11:30 am. Unfortunately the people who schedule such things are unaware of our other obligations such as clinic duty which starts at 11:30 am. For me that means I need at least 40 min commute time as well as time to gather xrays and mail to deliver to our clinic tomorrow.

It seems as though I've passed being chronically exhausted and moved on to just being sick. I left Bootcamp as early as possible, got home, threw up, put an icepack on my head and went to bed.
I read a lot over the weekend and downloaded a bunch of apps to my iPad pertaining to orthopedics, skeletal anatomy and radiology. This iPad I'm using now may be a huge key in helping me finish out school.
Next Monday is our first rheumatology exam. Hmmm, just checked the midterm grades posted to date ... Everything is well above passing and there's even three A's and a B so far in the mix. Of course, that may all get evened out after finals when extra effort gets put into the lower grades thereby ignoring the classes with the higher grades. There's only so much time to divvy up between things.

Thinking about classes... There's still a senior research class that I haven't progressed in beyond reading a book before Dr. Bub got fired so, I still need an advisor and god knows what else for that requirement.
I really detest that ride to & from St Peter's. My average weekly mileage for the past 6 weeks has been 652 miles per week ... Per mon through Friday and that's with skipping as much weekend BS as possible and riding my motorcycle locally.

A bit after 3 am, need to get some laundry done and half considering heading to the gym.

Tri-8 Wk9 Day 499 - Friday - 7/8/11

What happened this day???? I think our Dx Imag IV grades were posted and, in spite of meager preparation on my part - actually none, I still did fine and will get through that class as long as I don't Attendance Fail (AF).

I had clinic Friday. No patients, not on any list to take walk-ins, just needed to be there. I did get to talk to a classmate at lunch who was loving this semester so I asked him how many clinic days he had per week. He seemed a bit perplexed by the question and answered 'three' then was surprised to learn I've had mandatory 5 day per week clinic since the beginning of last month.

Monday is going to be our 500th day of class. Amazing. 500th day in the DC program which correlates to about 3,500 hours worth of classes. I've got so much to do.

I did skip the Loomis Internal Health Specialist (IHS) program this weekend. I guess I'm starting to have a psychosomatic effect with regards to driving. The thought of getting into my car for another jaunt to Logan literally made me queasy. I've definitely felt like throwing up more times this semester than any other time in my life.

I checked my mileage from the last time I got my oil changed and was a bit stunned to learn I've put in 4,000 miles of driving in the past 6 weeks - that's over 650 miles per week and I tend to ride my motorcycle locally so the vast majority of those miles are nothing but school related. It's just insane.

I just need to get to work. Unfortunately, the first thing on my agenda today is to get my car in to have my tires rotated and hope to god that has a positive effect on driving performance. It should help but I really thing my ball bearings are going out.

Tri-8 Wk9 Day 498 - Thursday - 7/7/11

This was my birthday and the day my clinician was accusing me of being a cause of changes in the office such as the clinic having to hold meetings twice a week and allowing interns to attend the meeting of their choice. I know other students that are happy about it but it doesn't affect me in the least because I already had a clinic shift on our meeting day.

What was his line ...oh yeah, "I've been hearing your name a lot" I think he said that at least a half a dozen times while telling me how some students have really learned how to play the game and if one student isn't happy blah, blah, blah ....

There wasn't any actual conversation, just someone that needed to off on a little rant and assign blame to someone. I can think of several people who may have complained specifically about the meeting days because it caused them to have to be in clinic 4 days a week but that certainly wasn't me.

This reminds me of an old job where a female friend of mine was having an affair with another guy at work. The husband kept suspecting me which was never the case but, as long as he was focused on me he never saw the reality of the situation. Similarly, he just needed someone to blame.

Tri-8 Wk9 Day 497 - Wednesday - 7/6/11

same crap, different day - dxi4 midterm today - didn't study a lick but passed it with a bit of a cushion to spare. got caught up on all of this weeks dxi/radiology module and will turn in the remainder of that tomorrow.

my 45th birthday is tomorrow and I can't really recall any time in my life when I've been less enthused. I'm just beat. dead tired beat.

I slept and napped more over this break than any other time in my life but it didn't seem to add up and help like times in the past. I'm just beat.

Almost bought the farm tonight on my drive over to clinic. Honestly, I was too damn tired to be driving. The second close call kept me awake for the last 5 miles of my trip to clinic.

I've got joints hurting that have never hurt before in my entire life - seems to be a theme - which joints? pretty much all of them.

Thanks Logan.

Tri-8 Wk9 Day 496 - Tuesday - 7/5/11

I don't really remember anything that happened this day ...clinic, patient ....

Tri-8 Wk8 Day 495 - Friday - 7/1/11

took a vacation day from clinic today ....wanted something to look forward to ....a jump to the 3 day holiday weekend ...ended up catching up on school stuff until 6 p.m. ...about the same time I would have gotten off clinic but, at least I was closer to home

Tri-8 Wk8 Day 494 - Thursday - 6/30/11

kinda envy those students who can run home at 11 a.m. ....instead of dredging through until 8:30 p.m. to get home ....

Tri-8 Wk8 Day 493 - Wednesday - 6/29/11

I drive enough to get my CDL ...

Tri-8 Wk8 Day 492 - Tuesday

Walking Zombie ....

Tri-8 Wk8 Day 491 - Monday

I'm thinking of those paint can shakers you see in hardware stores. I feel like my nervous system has been removed, put in one of those shakers for 20 minutes and then reinserted back into my body. I feel like my muscles have been put in a punching bag and gone over by Muhammad Ali. My neck feels like someone decided to play a joke on me and squirted super glue in my joints. My left elbow still has the olecronon bursitis but it's my right elbow and shoulder that are hurting. When do they hurt? They hurt when I move! I'm wearing compression socks to help combat all the time I'm sitting, but getting pains deep in my thighs which, I can only correlate to arteries deep in the leg.

One of the 26 reasons I had for going to school was due to dissatisfaction at the low activity level inherent with my old job. My old job was great but before I was ensconced with that job I weighed 222 pounds and was benching a robust 515 lbs in competition. Outside of competition I was looking at benching 300 pounds over my body weight. I started with SAVVIS towards the end of 2003 and my last marathon was towards the beginning of 2004.

I'm not exactly sure what to do. I lost the two days a week I had off from clinic due to Case Reports and now I've lost the two free hours I had before going to clinic on my days off due to patients. Patients are a good reason, it is very easy for me to care about other people.

...

oh well - less than 300 days to my first potential graduation date ...August is probably going to be more likely. Already lost one class and on the verge of attendance failing another. only so much I can give ...

Tri-8 Wk7 Day 490 - Wednesday!

I'm keeping this to a 12 hour day today which is an ambiguous way of saying I'm not making it to my Nutrition class this morning and will be leaving home around 8 a.m. and getting home around 8 p.m. after my clinic shift is over.

I've got a smorgasbord of thoughts & ideas, a plethora of pensive passions, and a couple of thoughts on how I'm going to spend the 4 days off I have coming up. Physically, I've turned to mush as well so, one of my first thoughts regarding the time I have off revolves around getting into the gym. Sleep is a HUGE priority and I'm pretty sure there will be a double sleep session starting tonight which means I'll be sleeping through the night, get up then probably laying back down to sleep again. This double sleep pattern is how I first dealt with the sleep apnea, before I had my bi-pap machine and was the reason I first went to see my MD because I wasn't having much of a waking, productive life anymore which was disturbing, to say the least. There is nothing more powerful I'll be able to do to reset my brain and infuse a more positive, happy outlook on life then to get rested with productive sleep.

After gym time & sleep, the third thing on my to-do list will have to concern school. Geez ...I can just feel the dissonance swell up in my brain at the mere thought of dealing with school. I noticed Dr. Shay had added this blog as one he was following and I recall when I first saw him after quitting the pledging process with his fraternity when he mentioned he noticed some kind of psychosomatic response from me when I first saw him. I sure didn't mean any personal or bad reflection on him but, he may have been correct in his assessment. I can feel that same type of response when thinking of school ...a very distinct and noticeable firing of neurons in my brain which tend to produce a not so pleasant emotional response.

As far as what I can "handle" with my current self, I can think back to those pledging days and say with a fair amount of certainty that 16 to 18 hour days were too much and these current 12 to 14 hour days are kind of on the cusp of survival and still being able to progress and move ahead with school.

Mail is a fourth consideration to deal with during this 4 day break.

Tri-8 Wk7, Days 488 & 489 - Mon & Tue

The blogs have been getting more sporadic lately and all I can say is ....5 mandatory clinic days per week, 12 to 14 hour school days - everyday and 35 hours of classes. Oh, and up to 3 hours per day in my car driving. Although, there have been days with as little as 2 hours & 40 minutes :)

Beat, sore & exhausted would be the first adjectives that come to mind when describing my current state. My brain is mush and with that mush & fatigue comes a less than positive attitude and some of the crummiest thoughts I've maybe ever had.

Tri-8 Wk6 Days 485, 486, 487 - Wed, Thur, Fri

It's early Sunday morning (about 1:50 a.m.)

Tri-8 Wk6 Day 484 - Tuesday

I've been home for less than an hour but, it's already after 9 p.m. and I'm pretty much obliterated and could fall asleep at the drop of a hat. Let's see ...yesterdays comment asked who's Korina. As I understand things, she was the Director of Social Media at Logan. As far as specifics, one would have to ask the parties involved. To me, the situation reminds me a little of when I worked as a Realtor back in '95. I remember I wanted to bring my computer into the office but that was forbidden. In my situation, I think the technology was a bit too new for the Broker I worked for but, now-a-days that same company does have a website and everything you'd expect of a Real Estate office. Maybe there's some parallels between the two situations. Maybe not.

I had my 2nd patient today. and ....that's about all I can say about that. LOL HIPPA, ya know. My first patient was this past Friday and, looking back, I probably should have come in Saturday to get all the paper work completed. Of course, it wasn't until today that I saw, first hand, how much was involved. Plus, I already had plans to go to the Ozarks Friday night which kind of precluded going into the office on Saturday.

I did catch an email at work another intern was looking at regarding recent firings at Logan. An interesting part was that Dr. Goodman (current president of the college) starting teaching back in 1968...and he's still with the college! That's about as impressive as it gets. 43 years with the same institution.

There was talk a month or so about a letter that was going around - not an email, but an actual letter critiquing the school and top administration. I think part of the gripe was about salary but, the numbers I heard were actually a little lower than I expected.

There's two things I keep in mind regarding the upper echelons of our administration. 1) There's a chiropractic school out West that's closing it's doors after the Summer semester and 2) Logan is putting up *another* brand new building. So, the people in charge must be doing something right.

My personal gripes tend to be indigenous to my own, somewhat unique situation and most can easily be avoided by simply not living an hour away from the school and also by not waiting until you're in your 40s to go to chiro school.

It's damn hard, I can tell you that. It looks like being away from home for 12 to 14 hours a day is going to be pretty standard. I was thinking this morning, it's like with each new thing that pops up there's a feeling of dread and loathing and then you try to accept it the best you can.

The driving is pretty nuts. Without any bad traffic, I'm putting in about 2 hours and 40 minutes of driving per day. Originally, I was mostly concerned with my blood pressure going hypertensive again like it did when Hwy 40 was closed down but, in spite of my drives being longer, the traffic jams aren't near as bad as when that main highway was closed. My main issues tend to be with sleep and upper arm joints - shoulders & elbows along w/ the ever more frequent parasthesia in the arms & hands.

I sort of remember with fondness how blog entries from a year or two ago were more fraught with interesting things that I learned in class. But ...I can't really remember anything from my classes and there's too many to remember without referring to a schedule or writing them out.

hmmm, OK - I looked at the schedule and am not sure what to make of it. There's too many classes to go through at this time.

I have a PT III practical on Thursday and I've still got to get done the Dx Imag (xray) original interpretations and Lab Interpretation, Case 4 by Friday. I need to get a blue sheet for my senior project turned in ASAP. I don't think Neuroplasticity & rehabilitation as it relates to Stroke patients will be my topic anymore because that was Dr. Bub's forte. I'm not sure who I'll get.

I think part of the griping by recent graduates may have had to do with moving classes into Tri-10 which somewhat precluded upper tri students from retaking classes they were unable to get through in previous trimesters such as 7, 8 or 9. I've just got 8 & 9 to get through.

I don't know. One moment at a time here. And, this moment is begging for sleep.

There is some relief with having a patient to care for because it precludes one from becoming too bogged down in their own trite issues. I've got my homeowners insurance paid again ...looks like I had forgot to do that when it was due - just have to get word to the bank that I'm covered again. Banks are kind of particular about that sort of stuff. Property taxes are another concern but, I've been charging almost everything I can to conserve cash. I think I can get by with a grand if I put off Part IV boards until next May. I know my car needs some attention, it sounds & feels like bearings may be going out. I'd like to at least get my tires rotated. Which reminds me - I need to ask off for next Thursday and Friday. Those days will be golden for getting some personal life stuff taken care of. There's maybe a form to fill out at the office for taking vacation days but I'm tempted to send Dr Hogarth an email asking for the days off - at least it might serve as a reminder if he says something to me tomorrow.

Dr. Hogarth is my clinician at St. Peters. He's very good at his job and does a good job tolerating me. Dr. Kane is the other clinician. As interns we get split up between these two doctors. I really wish I had something class related to talk about -- still don't remember anything...let's see ...

Wed - Class - Clinic Meeting - Clinic

Thur - Class - Clinic Case Reviews

Fri - Class - Clinic

Sat - Class

Sun - Class

Monday - Class - Clinic Case Reviews

Tuesday - Class - Clinic

Wednesday - Class - Clinic

and ...hopefully - praying - I can take two vacation days - one on Thur and one on Friday - we don't have school those days due to homecoming which ...is something else I really haven't gotten to enjoy mainly due to the long commute to school.

Geez - i have to get some clothes washed for clinic tomorrow!

Tri-8 Wk6 Day 483 - Monday

All kinds of excitement going on at the Logan campgrounds as of late and, I guess this would be the time of night, after I get home, that I'd discuss such things with my wife but, she's been dead for quite some time now so I suppose this blog is as good a substitute as any.

In the last week we've lost Korina, Dr. Scott & Dr. Bub - FYI - The only only person I know that's gone 100% is Korina. Dr's Scott & Bub have yet to be confirmed through official channels.

Without a doubt, Korina was the nicest looking of those three to be let go however, Dr. Bub was going to be my senior advisor so ....hmmm ...maybe I go back and try with Dr. Kettner? I'm not sure.

Bub has a diplomat in neurology. I'm not sure if any other teachers at Logan have that diplomat.

Korina is extremely interesting. I would like to have gotten to know her better.

So very few people that we meet really get remembered for a very long time. I can't even remember all the Walgreen stores I've worked at much less all the people I worked with. Just a smattering of memories.

Tri-8 Wk5 Days 481 & 482 - Thur & Fri

placeholder - went to the Lake of the Ozarks after clinic on Friday - Takes less than two hours to get to the condo from St Peters and, it's taken me as long as an hour 40 minutes to get home from St. Peters so ....for an extra 10 minutes of driving, the lake is well worth it. In fact, Saturday, I got more studying and homework done then any other day of this semester. Might have to do this again. :)

Tri-8 Wk5 Day 480 - Wednesday

oh yeah, i had a comment I still need to post about the majority rule thing. In my head I was thinking about things like smoking where, since only 25% of the people smoke and 75% do not then it's alright to toss people who smoke out in sub zero or heat warning temperature

or, with school - a majority of people via the lottery will end up pretty decent so there isn't any need to worry about the exception like me who lives 50 miles away from his clinic and has to be out there 5 days a week -

how freakin crazy is that?!

I started out with 4:30 a.m. alarms on Mon, Tue & Wed ....slept through them until about 5:30ish

My intent was to get out and get some exercise in.

I'm so trashed physically right now it's not even funny.

kind of thinking of riding my bike tomorrow - have to see how my sleep turns out - hate to fall asleep at the wheel of a bike ;)

trying to recall what we did in classes today ....

oh yeah - lots of nutrition this morning -

The teacher actually had pictures straight from a Nobel winning paper from 1986 (circa)

it was the basis for how many think about cholesterol today. upon reflection, it's kind of so-so in light of today's knowledge but, it will be a while before any current studies and research actually become best practice ...research indicates it takes about 15-20 years before what's known actually makes it into "best practice"

Dx Imag III was after that for two hours. Dr. Kettner is always fascinating listening and thank god I record his class because the sleep monster was jumping on me during most of the first hour.

I'm almost too tired to walk.

I'll let the alarms continue to go off at 4:30 because, if nothing else, I've been getting to school on time.

too tired to thik

i have heard I get 6 days off from clinic

I need to use two of those days during our upcoming homecoming otherwise I'll have to go up on Thursday for a case presentation and it will take me twice as long to drive there as it will to listen to the stupid presentations

Tri-8 Wk5 Day 479 - Tuesday

I had four different alarms on two alarm clocks all going off between 4:18 and 4:30 with 5 min delays. I was hoping for non-stop alarms going off but I didn't hear a darned thing and didn't wake up until 5:20 a.m.

If nothing else, I did make it to school with plenty of time to spare. Non of it really mattered as far as my activator class was concerned because I got kicked out. oh well. My best guess now is to drop the class officially and see if I can finish up the weekend activator class. This could turn out to be a good thing.

Just a big non-stop day, class to class to class to class and then straight to clinic where, today, I got the joy of sitting up in the office for 3 1/2 hours to do a whopping 2 minutes worth of work - if that ...however long it takes to write my initials down about 8 times when other interns turn in patient files. What an amazing waste of time and I'm quite certain this was just another in a line of time-wasting mundane things that was added to the curriculum.

I think it's one of those classic blunders when institutions think perfection is achieved when there is nothing left to add instead of considering the possibility that maybe, sometimes perfection is achieved when there's nothing left to take away.

From my perspective, I think Logan has a pretty strong program in the beginning and they're still struggling to get things figured towards the ending trimesters.

Honest to God, all this driving is just eating me alive. I spent an hour & 40 minutes getting home from clinic today. and the way those stupid Case Reports are set up, I have little choice but to deal with rush hour traffic on those two days as well.

My Evaluation of those Case Reports: Actually, they're probably one of the most worthwhile things I'm involved in this trimester and Dr. Hogarth does a really good job.

I've made it no secret telling other students how good I thought the clinic was at St Peters and I kind of wonder how much of an effect that had on the lower Tri's decisions when it came to picking their clinic since the St Peters clinic was one of the first to get picked & filled up.

Definitely a very worthwhile process - ie, Case Reports.

Definitely killing me and shortening my life. most probably anyway.

how hard can it be for the powers to be at Logan to consider students who own their own home and live out of state? they spend so much time trying to tell us how to care for others and yet we, as students, get short-changed so much.

and there is very definitely a "majority rules" type mentality at Logan. As long as the majority of the people are happy then consideration for everyone can take a back seat.

The whole thing has given me new appreciation for all those civil rights legislation's passed in years gone by. It's like the only way you can make certain people care about others is to make it a law.

Alarms are set - dead tired - scarcely got little more than an hour to take care of business at home after i got home.

Lab Interpretations & a Dermatology Exam this Friday ....

Tri-8 Wk5 Day 478 - Monday

Got alarms set for tomorrow at 4:18, 4:24 & 4:30 a.m.

Did what I could today.

Looking to do better tomorrow.

Tri-8 Wk4 Day477 - Friday

just kind of a placeholder here for last Friday.

Everyone seems fond of telling me there's only one year left.

Well, it's one year remaining provided I can get everything done that needs to be done.

BUT - it's not a matter of passing time. It's a matter of being able to do enough within that year's time.

It's more like say you can bench press 500 pounds but need to bench 600 in order to graduate. Maybe you can make it, maybe you can't.

This has really been an isolating type of trimester. Kind of strange. There are very few, if any people from my class that eat lunch in the cafeteria, I might see someone one day out of the week. Most everyone lives close enough that they can run home after our last class to change clothes or get a bite to eat.

My parents have kind of been scarce as well. I'm pretty certain I've heard from them more in previous trimesters but I think maybe I've heard from them once in the last three weeks.

Tri-8 Wk4 Day 476 - Thursday

PT III canceled this morning.

Still need to be to school by 9 a.m. to finish my mail duties from clinic.

If I didn't have outgoing mail duties yesterday at clinic I probably would have left.

Yesterday I learned PT - Physical Therapist are legally able to rate concussions in the state of Ohio however, Chiropractors are not - are you kidding me?! Are people really that stupid and ignorant when it comes to the education of a chiropractor?!

I pulled up the educational requirements for a DOCTORATE in Physical Therapy from Washington University, one of the most respected schools in the nation to see what kind of education PTs have in comparison to chiropractors. It looks like a very good program and I'm sure it produces some of the best PTs in the nation, probably the world but it's a far cry from the education of a chiropractor.

The program shows 4 entire semesters of Clinical Experience - kudos, this is a good thing.

However, when it comes to classroom learning the entire program consist of 5 semesters of classes. Only 19 hours of classes the first semester and a whopping 24 hours of classes the second semester. I've never had so few classes. I've been over 30 hours since my 2nd semester and currently juggle 35 hours *with* clinic! and we don't just have classes for 5 semesters - we have them for TEN semesters.

I'm not seeing anything in the way of hard core chemistry either - I don't see two years of chemistry and a year of physics as a prerequisite and I've not noticed either of those classes as requirements to become an RN either - another very highly regarded profession.

I don't see a year of biochemistry.

I do see one semester of human anatomy. At chiro school we have an entire YEARs worth of Gross Human anatomy which means we're dissecting the entire human body from head to toe.

I do see a couple of classes with the word "diagnosis" in them but not nearly as many dx classes as we've taken at Logan. We've have more diagnostic imaging diagnosis alone.

So, chiropractors have more than double the classes as a PT doctorate level program and yet we aren't capable of concussion assessments? Are you kidding me?

Jesus - in addition to that year of human dissection we spend another semester with the brains we've removed from our cadavers in another class called Neuroanatomy - and that's JUST the anatomy of the brain - we have other classes for pathology, normal function and neurology. Pathology - that's another class entirely missing from the PT program.

I'm not knocking the PT program - it's a great program and I'm half wondering how if I can get into the program - it takes less time and I'd have a good job waiting for me at the end.

Oh well - gotta get to school -

The first of two months worth of 5 day a week clinic duty starts today.

Something radical is going to have to take place to ensure my survival and I'm not even talking about just school survival anymore.

Tri-8 Wk4 Day 475 - Wednesday

Just shoot me in the head now.

I turn 45 July 7th. My new goal is to make it that far.

Tri-8 Wk4 Day 474 - Tuesday

Well, I think I might be moving on to acceptance of my crappy 600 mile weekly driving. What a bunch of crap. One interesting thing regarding learning about having to come in 5 days a week was that I only recognized one of those days one at a time even though I saw the entire monthly schedule every time I saw it. I think I only saw what I was able to handle. The first time I saw the schedule I only saw that I had to come in on Mondays and it wasn't until later on that day when I looked at the schedule again that I saw that I had to come in on Thursday as well.

I think if I'd have recognized that I was having to go in 5 days a week initially that I would have walked out of the classroom.

AND ....it looks like my marathon driving starts this week ... Hell - today alone I put on over 150 miles.

oh yeah ...I need to turn in a sheet for our meeting tomorrow telling how many people in St Peters I've met ...now, this is one of those things that should be available as a soft copy but St Peter's is a little behind the times when it comes to electronic records.

OK - that sheet's filled out and ready to be turned in

next - PT review application due tomorrow ...

well, that PT application has turned into looking up and scheduling all the logistics for my Part III & Part IV boards as well as PT as well as the one subject I need to retake for Part II.

I need to check w/ NBS if I can take the review for Part IV next year in April, just prior to May testing. I'm way too tired and stressed to remember much of anything and don't want to risk $1,235 on an exam I'm not sure I'll be prepared to take.

Tri-8 Wk3, Days 470, 471, 472, 473 - Tue, Wed, Thur, Fri

Apparently, clinic is now manditory 5 days per week. That's 120 miles of driving per day, 5 days a week MINIMUM! - 600 miles of driving per week - MINIMUM.

At this point, all I can say is Logan can go to hell.

With only 3 days of clinic per week I've already broken over 600 miles due to other activities such as marketing or ARC.

The extra two days per week are for listening to and presenting case reports.

I'm not really sure what to say, do or think about this latest development. It's pretty much insane and asinine.

We have senior research projects we're supposed to be working on and, with that, we are to procure a teacher from the school to act as an adviser. Asking a teacher to take on such a position seems to be the most unpopular question one can ask. It's not something most of them like to do or be a part of.

Part IV National Boards applications are now being accepted. I don't think I'm going to be able to pull the trigger on this. $1235 cash is required - no credit cards, just cash equivalents. Exam dates of November 11,12 & 13th. I've already put out over $600 cash for reviews. One of which I've already partially taken.

It's late Monday - Memorial Day. Class resumes tomorrow with day 474. There seem to be some schools where the students are enthusiastic about chiropractic but, I can't say this is necessarily one of them.

If things keep up as they have been then I can only imagine that if I ever manage to graduate then the last thing in the world I'll be wanting to do is practice chiropractic.

Tri-8, Wk3, Day 469 - Monday

Today was class from 7:20 until 11 a.m. and then I hung around and was able to get in four hours of rad conference in along w/ write ups for 5 sets of x-rays so, i've got half of the hours I need now for my Tri-8 rad conference requirement and I'll have to keep up the write ups for another five weeks.

We also have Lab impressions to do over the next 10 weeks and the first one is due this week. We get a case, i.e., 42 yof w/ c/c of blah, blah, blah ... then we get their vitals, CBC work, chem lab and urinalysis and need to provide a ddx and dx and how we would care for them.

Let's see ...last Friday was a 6:30 a.m. start at school, the preceding Monday ended at 11 p.m. Got clinic tomorrow, Wednesday and Friday. oh heck - i just remembered I need to update Dr. Hogarth on my adjustments - I *think* the 5 I did at ARC maybe count towards the 200 total I need to get in by graduation.

man it get's late quick - kind of a late night getting home but, only a 13 hour day so nothing unbearable. I do need to update my online Google calendar and sync it with my iPad - still have some other computer stuff to do as well regarding downloading materials for my 18 classes ---- nope - only 17 classes -

10 are structured classes that we meet w/ a teacher during the mornings and the other 7 are kind of like classes that we have to do on our own like the 10 weeks of lab impressions or 6 weeks of xray reports.

I really wanna think I can do this (get through the semester) and I really would like some decent grades to go with this semester. A few of those extra classes we're doing only have the option of getting an A or an F (or an incomplete) Getting it all done is the key. Dr. Guebert told us today that there are still Tri-10s with incompletes from Tri-8 coursework ...so ....wish me Luck! :)

Tri-8, Wk2, Days 464, 465, 467, 468 - Tue, Wed, Thur, Fri

Time to catch up :)

We can start with yesterday, Saturday, 5/21/2011 at Laurel Park in St. Peters, MO where I worked on six patients from the Cystic Fibrosis charity event walk. It was tough keeping a dry eye while listening to the stories of some of the people I worked on. The very first lady I saw told me the 12 year old girl she was walking for had died last week.

Friday was a day of early meetings starting at 6:30 a.m. followed by classes, then clinic then a stop at a classmates house who was having a little pre-party followed by the beginning of Tri party held at Hot-Shots over on Manchester in MO. I learned a few new chiropractic type moves both at the clinic and with friends later on at the pre-party.

OBGYN was rather interesting, our teacher is an FACOG, the American Congress of Obstetricians and Gynecologists or, a fellow. As I understand things, specialist like this are kind of like Mega-Doctors. After they put in their four years to get their MD they go on for another 4 years learning about a specialized area, such as OBGYN.

ACK! well, my computer crashed yesterday and it looks like what was written above is all that got saved.

oh well - the darnest thing about OBGYN is when we were talking about various secretions and watching slides of those secretions on a ladies fingers and the teacher commented that it was OK to touch a vagina ....then she recanted and said, it's OK to touch your own vagina. It was quite interesting though because, as she pointed out, the more serous effusion & clearer type of secretion was easier for sperm to swim through and thus make it easier to get pregnant. Something else the teacher mentioned and I kind of want to confirm this with more sources but it was mentioned that Green Tea can help produce a vaginal secretion that is more conducive and hospitable to sperm.

Last Monday, I spent the evening at the ARC - Adult Rehab Center sponsored by the Salvation Army in downtown St. Louis. They open their doors for medical type care on Mondays & Wednesdays. We mainly just did physical type stuff, blood pressures and so forth along w/ some physical therapies and some adjusting when indicated. I did get a couple thumbs up from a few of the guys w/ the A to P move I layed on them ;)

OK, better get this posted and update things for today. (Mon, Wk3) :)

Tri-8 Wk2, Day 463 - Monday - 50!

Let's see .....

My head is probably still a little in the sand but, I'm pulling it out and dealing with things the best I can. I did hit my 50th adjustment today ~finally!!! So, that will get rid of the Incomplete grade "I" that I had in HCP III. I also finished up the Gonstead retake over break to get rid of the F I had in that class. I think the only thing left to deal with is the F I got in SOT which, I simply stopped going to half-way through last semester. It was a ZERO credit extra class I was taking so I didn't think the grade would matter one way or another since it is a no credit class. I still have to find out but, maybe now I can get my student loan check which I *really* need.

Checking my mail, it looks like I've sold another shirt off Zazzle and got an email yesterday stating I had a check coming from Google for my Brachial Plexus video. That could be a nice little source of extra income. Once I see the money for real once, then the math brain shifts gears and I instantly figure if one video earns me $135 then 10 would put me over $1,000 and 100 well done videos might be able to give me enough per year to pay the property taxes on a pretty nice home.

I have ARC tonight. ARC stands for Adult Rehab Center. I have no idea what I'll be doing there but, the shift is from 6:30 to 11 p.m. Which means getting home late but still having to get up early. I think I still need to stop at the gym to invest at least 1/2 hour

I almost forgot, the highway leading to school was closed again this morning. It was closed Friday night when I was coming home from the Arthritis Walk I'd volunteered to help with then again this morning. This morning it was closed due to an accident and someone died.

Looks like I'm going to have a patient stopping by my place before I leave for ARC tonight.

Saturday Clinic Shift, Holding at Day 462

What a HUGE difference getting a decent night's sleep makes! Even though I spent almost as much time driving back and forth to work as I did with today's three hour shift, I found myself reluctant and sad when I had to leave work today.

When anyone has a new patient at the clinic we play our own version of House, MD with regards to the white board. All the available interns will sit around the white board and listen to the facts & findings about the case and are all free to contribute to the diagnosis (dx) & treatment (tx).

We had two pretty nice cases we reviewed today.

Heck again - I've got to get moving on figuring out all the work I need to get done for the coming week & semester.

Wk1, Day 462 - Friday

I gave my first school sports physical yesterday! He was a really good kid and his mother was quite grateful which was pretty darned nice. It was a big learning experience. I noticed any apprehension which was present before giving the exam was immediately replaced with caring once I met my new patient. Given the young age I tried to be as positive and emotionally supportive as I could with the young man.

Heck - gotta leave for Sat clinic shift!

Tri-8, Wk1 Thursday, Day 461

Just a single hour of PT III this morning. A much abbreviated schedule due to the Tri-7 comp boards going on today and tomorrow. I stuck around and got in an hour of my radiology conference requirement (1 of 10) and downloaded and printed out a bunch of material for most of my classes.

Tri-8, Wk1 Wednesday, Day 460!

pardon the brevity of these post -

yesterday was 13 hours long

today was 14 hours long

i don't know what tomorrow holds but

Friday is already scheduled to be 17 hours long

i work clinic on Saturday

and have some extra shift at some Drug rehab center in St. louis on Monday

need to beef up the dr bag to be able to handle some basic emergency type stuff, things like dealing with a pneumothorax (where to cut) and a cricoidectomy ...That was from Dr. Lanny

Then our Dx Imag teacher was mentioning needing to learn about different surgeries. who knows but, i do recall that our pharmacology class helped me the most in learning about why and how chiropractic is effective.

tough, tough schedule - really having my doubts

Tri-8, Wk1 Tuesday, Day 459!

1. Physiology
2. Chemistry
3. Clinical Sciences
4. Microbiology
5. Pathology // General Diagnosis
6. General Anatomy
7. Principles of Chiropractic
8. Spinal Anatomy
9. Neuromuscular Diagnosis.
10. Diagnostic Imaging
11. Chiropractic Practices

Rad Pos

[Holding at Day 458]

One final cup of coffee before I head off to school to jump through another hoop via Radiological Positioning and take a few x-rays of some phantoms. I'm looking forward to re-establishing my habit of stopping off at the gym on the way home from school. I have to think of exercise as another necessary class I need to attend in order to make it through these last three semesters. That attitude seemed to work well for me this past semester, in Tri-7.

The actual Tri-8 semester starts tomorrow - got plenty to do to finish getting ready.

Best Day of the Week, A Day Off, Friday Clinic

[Holding at Day 458]

[4 a.m.] I actually have a day off today!

[7 a.m.] (insert BIG time gap here) OK, I've actually just wasted 3 hours on the Internet! Oh, well, it's been a while since I've been able to do that and I have been enjoying some coffee and the light sound of rain outside my window (which sounds much better then outside my slightly opened garage door)

I did muster the courage this morning to look for a grade in the Gonstead class I just got done taking over my break (break?! what break???) At the very least, I do hope I passed the class but, passing grades alone aren't going to do much for my GPA. I at least want to finish the DC program above a 2.5 which, I'm already above but, can't afford crappy grades and still hope to maintain that GPA. I lose the opportunity to take Master's classes w/o a high enough GPA.

anyway - Thursday would have been the best day of the week because I got to have lunch with my Dad and really enjoyed the time with him.

Yesterday at the clinic was pretty fun also. So far, I tend to be happy there and the only drawback is that god awful drive. We're supposed to meet 5 people from St. Peters by our next meeting. I'm not sure how much time I can dally around in St. Peters to meet people but, I guess I'll have to make the time since I need to find 10 new patients before I graduate.

I've got an enormous amount of stuff to take care of, better get to it! :)

I was looking for a pic of just me and my Dad but today's pic will have to do. It's me, my Dad and my Grandma! :) Taken just ..geez, just 6 days ago up in Minnesota :)

Gonstead, Board Reviews, 4th Wedding Reception

[Holding at Day 458]

We had our Gonstead final this morning. 10 pages written. It was my choice to go to Minnesota this past weekend but, it was not a choice without consequences.

Prior to leaving for Minnesota, I had an 83% average during our first four days of class. In the four days after getting back from Minnesota my average was 48%. So, I went from a very respectable B (just shy of a B+) to nearly 20 points below an F.

That sucks

Makes me feel pretty crappy about myself.

Mondays test was one of the hardest, emotionally, and I just felt like a worthless piece of sh*t while taking that exam.

Today, I just wanted to crumple up my exam like that guy did on Shawshank Redemption when he threw it in the trash and said, "There's your two points!"

Then I thought (again) of Chevy Chase's Las Vegas Vacation when the blackjack dealer recommended "buying a bullet and renting a gun"

So, my thoughts are kinda in the crapper. I've wondered, from an academic perspective why all my anger and violent type thoughts are directed towards my head. From the beginning of Tri-7 the thoughts have oscillated between

1. wanting to flush my head down the toilet
2. shooting myself in the head
3. chopping off my head
4. stabbing myself in the temple with my pen (that was a new thought formed today while taking the Gonstead final)

I do recall various personality disorders and remember a distinction between those wackos who might hurt other people and those wackos that would only hurt themselves. I guess I would fall into the latter category.

As far as benefits of heading to MN, I know my Dad was happy and I got to take some pictures of my Mom with her brother so, in that regard, I'd probably do it again.

I still may have passed the Gonstead class but, given the diminished self perception over the preceding trimester, I really could have used something positive with regards to school.

oh well. .....

let's see, i've already driven about 84 miles today so I guess I'll start my next 50 miles to work ....then 50 miles home ....184 miles today alright - ....yeah ....this is going to work out well. ..... :(