Monday, February 28, 2011

Monday Classes & Board Review Cancelled

Tri-7 Wk8 Still Holding at Day 431

I continued to check out another chapter from a book called Freakonomics which, I believe was on the New York Times best-seller list at one time. Here is as best as I can remember what I understand from a chapter dealing with the crime rate in the United States. It seems the crime rate had peaked in 1990 and forecast for subsequent years were bleak and thought to continue to rise. Many politicians had their own reasons for why the crime rate actually went down after 1990 but, when examined by economist, those reasons could only explain about 50% of the decline since 1990.

The economist reasoning started with Romania and the execution of the Romanian President, Nicolae and his wife on December 25, 1989 following a revolution and a hasty two hour court proceeding. Back in the fall of 1966 Nicolae issued a decree outlawing abortions which caused the birthrates to double the following year and, an ultimate rise in crime leading up to the time Nicolae was executed.

The economist wondered if the opposite thing might have happened in the United States with the passage of Roe vs Wade back in 1973 which made abortion legal nationwide. The notion was that unwanted births were decreased so that by the time those births would have otherwise reached their prime ages for crime, they simply no longer existed because they were never born in the first place. There was some interesting data that went along w/ the supposition such as the 5 states which allowed abortion before the passage of Roe v Wade in 1973 showed a decrease in crime prior to the 1990 nationwide decline based on the number of years prior to 1973 that those states legalized abortions.

Some other stats cited where that in states where abortion was legal and easily obtainable as compared to states where abortion wasn't as readily available - those states showed a 30% difference in crime rates, w/ the more readily available states as having the lower crime rates. Then it was shown that the difference in crime rates (at the time of the study) all occurred in people aged 25 or less or, those people born after Roe v Wade and there was no difference in crime rates of people aged over 25.

Anyway, that's Freakonomics. I'm not quite sure what to think of it all but, it was an interesting diversion from studying.

School was cancelled due to a power outage.

Let's see ...latest update from Logan - We'll be at the Doubletree Hotel tomorrow for 6 1/2 hours of board review and then again on Wednesday from noon until 8 p.m. after having classes from 7:20 to 11. ....
hmmmm, there go more patient appointments .....oh well, I guess we do what we can do. I have to at least try.

Sat Graduation, Sun Workout


Tri-7 Wk7/8 Holding at Day 431

[Sunday night ~11:45 p.m.] Going backwards in time, I had a nice workout on Sunday after enjoying a nice breakfast with my parents. I had two days off from working out and I'm thinking the rest may have been helpful since I ended up getting in 50 minutes of cardio which included 20 minutes on a stair stepper machine and 30 minutes in a treadmill with inclines of no less than 21 degrees for 25 of the 30 minutes. I'd never used the stair stepper machine so I used it at level 1 which seemed very simple (only 30 steps per minute) but, after 20 minutes it still raised my heart rate close to 150. The super incline treadmill is another new piece of equipment in the gym and I've been following a program printed on a placard located on the front of the treadmill called the 3X Calorie Burn. I wasn't able to maintain the extreme inclines last Thursday for the entire 30 minutes but was able to today. I capped off the 50 minutes of cardio with some weights.

It's early Monday morning aprox 5:15 a.m. and I started this blog about midnight last night. Just got notice that Logan is closed today due to a power outage at the school. ...just had to check on KSDK.com (local news station) to make sure (Facebook is only so reliable) and sure enough both Logan and Maryville University are closed today. They're in close proximity to one another so it would make sense that both are without power.

The big thing this weekend would have been my graduation at Logan for a BS degree.

[Monday ~9 a.m.] Wow - I've awoken from my three hour nap to over a dozen messages on my phone. Let's see ...here are my "official" text from one of our class officers ...
5:15 a.m. School is Closed
5:30 a.m. School is Closed but Board Reviews are still on
7:34 a.m. School is Closed AND Board Reviews are cancelled ...

If the school is closed then I'd assume the bookstore and cafeteria would be closed as well. whatever - I'm glad I went back to bed upon the first notice otherwise I would have wasted two hours driving.

Anyway, I did graduate w/ a BS degree on Saturday. For some reason, blogger.com rotated my the picture of my diploma that I'm using as today's pic. This is a difficult semester. I think I'm going to throw on some workout clothes and head over to my parents house. My Dad and his training partner should be lifting today starting at 9! :)

Saturday, February 26, 2011

A Trip to the Dentist & 2nd Day of Board Reviews

Tri-7 Wk7 Day 431, Friday

As has become more and more typical over the preceeding months (years?) I continue to end my days remembering less and less of what's transpired over the course of my day. Remembering what specific things I've learned in any one class has taken a back seat to simply trying to remember what classes I've had. Many times the first question I have when a class starts is "what class is this?" I ask this to myself even though our teacher is present and I should know what class I'm in but, often I don't have an answer to my question until I look up at our over-sized schedule posted at the front of our classroom.

Isothenuria may provide an insight to my current memory issue. If a person gets a UA (urine analysis) and their specific gravity (SG) is checked say, once an hour for 3 or 4 hours and doesn't drink any fluids during the time they are being checked then that person's SG should increase which, is an indication that their bodies are retaining more fluids to help maintain homeostasis. In short, if you don't give your body the fluid it needs then the body says, "alright, no problem, we'll just conserve the water we have on hand until you drink some more" Sometimes the body isn't able to conserve water as it should and in these cases a person's SG will stay the same test after test. If the SG stays the same, instead of going up then this is known as isothenuria.
Isothenuria was an answer to a question on our first GIUG exam. I have not consulted a book or any of my notes but, I know the answer now. I knew the answer after I left the class room but, I could only come up with the prefix "iso" during the exam. (I better Google to make sure that really is the answer and not just what I think it is) Yup, that is the correct answer.

I am becoming more and more sensitive to the role stress plays on my physical and mental conditions. Oh, and maybe I should have said this before but SG of urine is an indication of whether urine is dilute or concentrated.

The fact that the answer of isothenuria came flooding to my mind after the test was over but not during the test I see as a symptom of stress. I know I have a great ability to put things together. To mentally and intuitively put things together but this process doesn't or isn't working optimally when stress is part of the environment. And, to be a little more accurate, I would say my performance is hampered with chronic stress, that is stress that has been ongoing for a significant amount of time. For instance; weeks, months & years as opposed to days which would be indicative of acute stress.

....insert yet another major tangent here ......

With many of these blogs it's like I'm getting only four bricks from an entire wall of bricks actually written down and if each wall were to represent a complete set of thoughts then there are several walls of thoughts where only a few bricks from each wall are actually conveyed.

It's a little after 6 a.m. Saturday as I enter Friday's blog entry. I've been up since about 3 a.m. but, I fell asleep last night around 6 p.m. so I've gotten plenty of sleep.

Rest, exercise and nutrition are the main treatment (Tx) plans I can avail myself to be able to improve myself in order to get through school and life. I've improved both the exercise and nutritional aspects greatly since being assigned the St Peters outpatient clinic location.

There is a pretty basic concept of surviving and thriving. For the most part, I've been trying to survive Logan however, to better care for my patients, I really need to thrive. I've been seeing a lot of the thriving and surviving concept as of late but the first time I recall seeing it was from a small sign which used to hang from the rear-view mirror of an ex-girlfriend which said, "Surviving is Essential but Thriving is Elegant". I can't say I've been thriving too much. I suppose there would be a ratio of surviving to thriving and I would probably put the surviving number in the denominator of the fraction since it is essential. (I guess this is my mathematical background coming into play...)

On a whole, we have 100% of our life to consider. If I'm spending 30% of my time thriving and 70% surviving then I'm looking at a fraction or ratio of 30 over 70 (30/70) or, more simply, 3/7. Whenever we are spending more time surviving than thriving then the bottom number of the ratio will be greater than the top number and if we divide those two numbers we'll get a decimal answer less than 1. So, 3/7 is equal to 0.43 which, is less than one.

If we are spending 50% of our time surviving and 50% of our time thriving then we have 5/5 or 1. If we are thriving more than surviving then our numerator (the top number) will be larger than our denominator. Let's say I'm thriving 60% of the time and surviving 40% of the time then our ratio of thriving over surviving is 6 over 4 (6/4) which is equal to 1.5

I'd conclude that having a number greater than 1 is where we would like to be. This reminds me of Steven Covey's book, The Seven Habits of Highly Effective People. Where do we get the time to thrive instead of simply surviving? That would come from those things which are not important and not urgent. Steven has a quadrant set up using Importance and Urgency as two criteria and either of those items may have the word "not" in front of them which gives us

Important & Urgent
Important & not Urgent
not Important & Urgent
not important & not Urgent.

I think the notion of Thriving would have to do with engaging in activities which are Important and not Urgent. Studying for an exam which is three weeks away would be an example of something that is Important but not necessarily Urgent. Buying health insurance may be important but not necessarily Urgent.

Surviving would be engaging in task that are both Important and Urgent. I have a test tomorrow - Important and Urgent.

The phone is ringing ...that may not be important but may qualify as Urgent since it demands immediate attention as whether to answer or not. Writing in my blog may be important but not necessarily Urgent.

not Important and not Urgent ...probably playing a game on the Internet would qualify.

The overall concept is pretty simple. Is life pushing us or are we pushing life? The more life is pushing us, the more we are in a mode of survival and higher stress. The more we are pushing life, the more we are in a mode of thriving and less stress. That is how I see it.

I suppose I write this blog not only to track the number of days it takes to become a doctor but also because I generally don't have anyone else to talk with. Living alone has it's pros & cons and one con is the lack of someone else to share things with. In talking through these notions I'm looking for answers.

Emotionally, I feel as if there's an avalanche of things hanging over my head and pieces of that important mountain of things are continuously falling on my head. How I deal with those things is going to determine the quality of my life.

If I let time pass by and am not actively engaged in facing that mountain the the passage of time will cause things on that mountain to be pushed onto my head, one at a time, maybe a few items one right after another, maybe 4 or 5 items at a time ...this has been happening a lot lately.

If I'm letting time pass and these items get pushed then I can either try to catch the item and deal with it in as effectively a manner as I am able or, I can try to shield my head and duck. I see shielding my head and ducking as doing anything to avoid dealing with the issue that's falling on top of me. It's avoidance. I could go out and get drunk or immerse myself in a movie. This avoidance is probably a root cause of many of our so called bad habits. Clearly, in order to thrive, I need to catch as many of these items as possible and actually deal with them instead of shunting responsibility.

Now, there is time that's available to me when nothing is being pushed on top of my head. Times when nothing would be imperatively urgent. We might call these times, the weekend or early mornings or end of the day or end of our work or school day. It is in these times that I need to face the mountain of task and choose and pick amongst the myriad of opportunities and issues that confront my life. This is a part that can get confusing. It isn't always a matter of picking from a mountain of things that are getting ready to fall on my head but there also seems to be a mess around me of things that have already hit me on the head and are now scattered about me on the floor waiting to be picked up.

I'm guessing this is the most round-about way of simply asking the question, "What am I going to do this weekend?" I don't have too many weekends to avail myself with. I have a graduation ceremony this morning and my parents will be attending and picking me up in a little over an hour ...thus, getting ready becomes more and more urgert ;)

Have I laid the groundwork for any great breakthroughs? I'm not sure. I've certainly thought things through but, what am I actually going to do?

The task currently at hand are more than I can come up with off the top of my head.

....insert 20 minute gap here as I get ready to leave this morning ....

There is one basic concept that could round up the reason for much of this writing. It's the same reason that millions of people will buy things for reasons such as losing weight, quitting smoking, regaining lost hair, get rich quick or anything else people wish to change in their lives. The reason so many of those commercials can sell a product whether the product is worthwhile and real or not. The one thing that precipitates everything else before a call or purchase is made is, quite simply, hope.

Hope is a fundamental concept and one I've delved into many times before. Hope is inherent in the forgiving nature of having multiple days or a future of any sort. I imagine hope is the last thing lost when a person commits suicide. No hope for anything better in the future. But, hope is also what propels us to move forward. Hope is what allows us to keep trying time and time again regardless of the number of failures we've had previously. Hope that our future can be brighter than our past.

My mind is constantly referring back to my patients, both the ones I have now and the ones I'll have in the future. I would wish for them, Hope, Health and Happiness. Maybe that would be a good name for a chiropractic clinic.

...I don't really have time left to continue with these current lines of thinking. As an ending to this current blog post I'm thinking that Love & Hope would seem to go together although I'm currently inclined to see them as separate, high level entities which may or may not be related. When it comes to hope, I am currently inclined to relate hope to beliefs which elucidates previous thoughts on the matter of hope. Beliefs are an interesting concept. Beliefs tend to be related to patters that we find in the world. Patterns of outcomes. An interesting concept pertaining to beliefs is that, as people, we will tend to see patterns more often, even if no such patterns exist, more frequently when we are feeling out of control with out lives. A prime example of this can be seen with baseball players. There is little superstition related to a ball palyers performance when it comes to the task of fielding however there is, relatively speaking, a much greater preponderance of superstition when it comes to hitting.

Now, here we will need to be clear on what is meant by superstition and, in this context, superstition refers to seeing patters of behavior that will produce a certain outcome when there isn't necessarily a basis for believing the pattern we are referring to as superstition.

If you've got a handle on that last paragraph then also keep in mind that the more out of control we are, the greater the tendency to see patters (have beliefs) that don't really exist.

Baseball players who are playing in the field have a success rate of around 90 to 95%. However, a successful batter, say someone with a 0.300 batting average (which is successful) means that they are failing 70% of the time. This would correspond to a situation where they are out of control since the failure rate is so high. This relates to the fact that, when it comes to hitting, there is much more superstition (seeing patterns where there are non) related to hitting than fielding.

Time to get ready. We'll conclude these thoughts after my graduation today :)
Apparently, I've been doing something right to make it to Trimester 7 at Logan and have a graduation today for some BS degree. LOL I'm not even exactly sure what the specific degree is, something like a bachelors in Human Biology or Life Science or something like that. Not that I'm underestimating or don't appreciate the degree but, the main degree we're after is the DC degree. However, this will be great practice and aid in visualization in walking across that state in the Purser Center for the real thing. :)

Thursday, February 24, 2011

NBS National Board Reviews for Part II Boards & CCAT!

Tri-7 Wk7 Day 430, Thursday

Our classes for the next four days are being replaced with Board Reviews. We hit it today from 8 a.m. until 5:30 p.m. Our instructor, Dr. James is absolutely fantastic. The man has an alphabet of letters behind his name - BS, MA, DC, DAAPM, NMD, LCP. I'm not even sure what half of them mean!

It looks like Part II is analogous to the USMLE Step 2 that the med students take. Our instructor described the exam and "hairy and ugly" I did get a cool comment posted by a student living over in the UK who was looking for Rickettsiae. Last year there was a med student from the UK who had some great post on YouTube dealing with saltatory conduction.

It's hard to remember everything we covered today. I know we ended with OBGYN and I learned plenty about the placenta. We covered things like cystocele's and rectoceles which I'd seen live pictures of from in our Physical Diagnosis class last semester but some of the drawings we saw today really helped to solidify that knowledge a little more. I do very well with simple drawings to help initially get concepts. With the female we have the bladder, then vagina, then rectum all next to each other and in that order when viewed laterally. When the bladder herniates into the vagina we have a cystocele and when the rectum herniates into the vagina we have a rectocele. We also saw how the uterus can prolapse or protrude out of the cervix, especially with multiparous (multiple birth) females.

I think my favorite part of the OBGYN was when I got to see the space available for a live birth. On a lateral xray view of the pelvis, a line is drawn from the front and top part of the sacrum to the top of the pubic symphysis and that's called the conjugate line and that's the space that a baby would have available to fit through. It's just one of those things I'd been wondering about and was happy to get educated on it :)

We also covered a chiropractic adjusting technique called the Gonstead method named after Clarence Gonstead. This reminds me that sometimes I'm asked how much money a chiropractor makes. There's no definite answer to that since most chiros have independent businesses. Some don't make any money and have to find other means of support while others are amazingly successful. Clarence Gonstead was one of the very successful ones. Dr. Gonstead's office was so large that half of it contained a 28 room hotel while the other half was for treating patients. His office also included swimming pools, tennis courts and a full sized golf course. His house was equally amazing. I saw an over head view of his home in a class last week. The teacher pointed out one building which had his indoor pool which then led to his outdoor pool. His back yard consisted of a landing strip and six airplanes that he owned. I'm thinking the man must have been doing something right and must have helped a LOT of people in order to build up such an empire.

A very interesting thing our teacher conveyed was when he talked about one of his patients who shared the fact that he and his wife had recently been approved for adoption. They had been seeing conventional doctors for six years in an attempt to get pregnant but finally conceded defeat. Our teacher, Dr. Cranwell, suggested he bring his wife in to see if he could help. Obviously, helping women get pregnant isn't something most people think of when they think of a chiropractor but, the mans wife did come in and after an xray evaluation they found that the womans pubic symphysis was offset to one side by 22mm! (nearly an inch, for my American friends) ;)

Dr. Cranwell treated the lady for a few weeks to help correct this misalignment and shortly after that her husband came in the office and was very upset. It seems corrected that misalignment may have solved their problem and the lady ended up being pregnant with Triplets and this was in addition to the child they had already agreed to adopt! Probably a good problem to have :)

We also learned that sometimes chiropractic adjustments can help with cryptorchidism which are undecended testes. This usually occurs with the 2nd part of the sacrum is displaced anteriorly.

The big things we usually hear about in school regarding what chiropractic helps are things like asthma and enuresis (bed wetting). It's kind of odd because once we get licensed as a real doctor then we seem to be limited in how much we can share that information. I know my brother got in trouble a number of years ago when we shared that kind of information in an advertisement and had to drive up to Chicago to face a disciplinary board.

Wow! I just went off on an Internet tangent but it was rather interesting. I noticed the NBCE (National Board of Chiropractic Examiners) now has a CCAT link. A Chiropractic College Aptitude Test. This makes me wonder how far away Chiropractic colleges are going to be from simply offering a combination DC/MD degree program.

I'm glad the standards are being raised. I'm reminded of the Boston Marathon and when that organization first started to impose requirements for getting into the race. The race officials originally wanted to be able to limit the number of entries but the challenge ended up making the race more appealing so entrants just went up! We need that with chiropractic. There are about 60 to 70,000 chiropractors in the United States and about 400,000 Physical Therapist. We hear time and time again how well organized the PTs are not to mention how proficient they are at their job. I'm hoping the chiropractic profession can eventually learn from them.

Being almost 70% through the program now I can see that becoming a chiropractor basically means learning all the stuff you'd expect a conventional doctor, such as an MD to learn and then learning how to adjust on top of that. As far as what we do, I'd say there are two things. One, we diagnose and two, we adjust. The diagnosis can be anything under the sun and the adjustments may be with any two articulating bones in the body.

My god ...it's almost 1 a.m. and I still have to finish a quiz for Applied Kinesiology that's due at 6:30 a.m. I better get moving.

Today's picture is a cut-away side view of a pregnant lady 28 weeks along. I added a line to show the conjugate line and hence, the space available for the baby to pass through ....not that the cervix doesn't have a whole lot of dilating to do as well. Yowza! (kind of glad I'm a guy) ;)

Wednesday, February 23, 2011

Dress to Impress, Live to Inspire

Tri-7 Wk7 Day 429, Wednesday

It was over Christmas break when I came up with the notion, "Dress to Impress, Live to Inspire" I'm not sure exactly what thoughts led to that quote but, I've often found that considering diametrically opposed ends of a spectrum can often lead to easily seen insight. I'd put Living to Inspire at one end of the spectrum and consider committing suicide at the other end of the spectrum. The thoughts may stem from an ultimate objective to live an inspiring life and that leads me back to one of the 26 original reasons for quitting my job at SAVVIS and heading to Chiropractic school at Logan which was to put myself in a position where I'd probably be forced to become a better person in order to complete the DC program.

I'm guessing the quote could be stated as, "Dress to Impress but, Live to Inspire" and perhaps this is just an objective that I tend to hold as significant. It reminds me of the quote I once read that was attributed to Benjamin Franklin, "A good example is better than a good sermon"

Either the example or sermon may serve to inspire but the example is more powerful.


Leaving my SOT class was a big hiccup, somewhat like a major correction in the stock market. The weekend kind of sucked and was not an ideal time to be isolated and alone but, that's where I found myself. I was grateful to get moving again with school this week. It's the best thing I could have done. Everything seems to be better in the groove and not so much when I'm thrown off the horse onto the isolated desert.

I again had my breakfast burrito and OJ for breakfast and salad for lunch and hit the gym on the way home. Stopping off at the gym on the way home is ideal. I don't necessarily always want to go there, mainly because I seem to be perpetually exhausted but I can pretty readily see that if I were to go home first that my odds of ever making it to the gym would be next to nill.

...I still can't remember what classes I had today ....going backwards I think I can reconstruct ....
HCP III was the last class for two hours. We went over lab test we can do for our patients such as Urine Analysis, Chem Panels and CBCs.

Dx Imaging III was before that but, I was involved with another new patient and by the time I was able to head to class I learned that class was already over, on attendance was taken and our teacher was out of town until next week. After an initial exam with the patient I set up a diagnostic ultra sound to confirm a diagnosis of a benign lipoma which, fortunately ended up being correct.

Oh, we had our PT II midterm exam this morning and it was *spectacular*! I'd left home this morning about quarter after 5 but didnt' get to school until after 6:45. The long drive was due to some unexpected ice on the highways this morning which resulted in no less than 16 accidents in the metro St. Louis area, two bridges connecting Illinois to Missouri being completely closed and a huge pile up of cars on east bound Hwy 40 which involved somewhere between 21 and 26 cars and semi's. But, the great part came with the exam. I got to question #3 and was thinking the exam was a bit harder than expected when the guy sitting behind me pointed out to the teacher that the exam was actually for PT I (last semester's class) ... LOL!
The teacher realized the mistake and told us all to just hand in our scantrons and said he'd give us all a pass on the exam. I'm not exactly sure what that means but considering I lost the hour to study I had allocated it was a very welcomed surprise.

had to break down and grab my schedule ... we had Applied Kinesiology then Geriatrics after PT.


Tuesday, February 22, 2011

Tri-7 Wk7 Day 428, Tuesday

Checked out St. Peters today. It's a heck of a nice place and kind of HUGE. It's got several rooms with diversified tables, rooms with Cox flexion/distraction tables and even a room in back with an Activator table. The PT room is also huge with about 4 tables and each one has interferential type machines, a cervical traction unit and a k-laser. I should have brought my camera. There's a nice looking bar and grill to the left of the clinic and a beauty college to the right.

We'll see what happens. I just need to keep my blood pressure well under the 205 over 110 range and I should be OK. I'm doing what I can. I've had nothing but salads for lunch and still hitting the gym every day on my way home from school which, includes tonight. Dinner was asparagus and salmon with V8 to wash it down.

School was good. I had two patients scheduled for this evening but only one showed up. It's kind of odd, I had Dr. Perillot sign my sheets and observe my adjusting. She's nice as pie but I still get so wound up that by the time I was done with my patient I felt like I was going to throw up ...not exactly sure why.

Dr. Jason kept us updated on the political side of chiropractic. He certainly keeps things real. I've heard Dr. Montgomery has chartered a bus for tomorrow to take students to Jefferson City to help support upcoming passages of Bills relevant to the chiropractic profession.

Dr. Kuhn ....whew! You certainly get your money's worth in that class. He probably fits more information in an hour than some teachers do in 3 or 4 hours. I've had a pretty good understanding about how edema works in the lungs but today in GIUG we heard about edema with regards to the intestines and how that inhibits absorption of nutrients like protein. I'm guessing the mechanism is similar to how it is in the lungs. I guess that assumes capillary intervention with the intestines which, makes sense. The interstitial edema would increase the physical space between the intestines and capillaries. Anyway, I thought it was interesting. There's a ton I have to learn.

I was still in a funk this morning and didn't get underway until 6:30 which meant not making it in time for my first class which, I thought was geriatrics but it was actually endocrinology which I absolutely didn't mean to miss. Then I'm thinking i'll be able to make Endo tomorrow when I learned today was Tuesday and not Monday.
The night ended a bit odd after I pulled into the garage. I was taking my bookbag out of the car and knocked off my rear view mirror. :(
The mirror actually took with it a piece of the glass from the windshield.

I kind of wonder if a conglomerate type of course could be taught with regards to adjusting techniques. There's some really amazing stuff out there.

I'm unsure about a few things regarding my classes. SOT in particular.

NO FREAKIN WAY ..... there's talk of closing part of the bridge on hwy 70 leading into St. Charles ...that's the bridge I have to take to get to the St. Peters office .....hmmm, it sounds like bids are going in this Fall. I might escape one there. I keep trying to tell myself God had a plan different than mine and maybe He knows best.

I'm still not exactly sure how I'm supposed to garner patients in a town that's 50 miles away from where I live. I've been a licensed real estate agent and I don't think it's all that reasonable to think I could get my home listed with an agent, sell it and then have it close during my last break which is maybe two weeks at best.

I think we have one student in our SOT class who is already a doctor so I'll still be able to properly learn the technique at some time. I've got a ton to learn.

Given the table selection at St. Peters I think I'd like to take the Cox Flexion/Distraction class as a specialized technique but ...I'd also like to continue on with my Activator training.
We only have one more day of classes this week, which is tomorrow then we'll be in NBS Board Reviews for Part II national boards.

anyway ...I've got a Physical Therapy II midterm exam tomorrow and an Applied Kinesiology exam due Friday ...got my work cut out for me. time to hit the sack and get up early.

Saturday, February 19, 2011

Day 427, Weekend Edition - SOT gone?

....this was my meltdown over the weekend....

[11:30 p.m. - Saturday] This morning started out as planned, got up early, left the house at 6 a.m., hit Irene gold at 7 a.m., ran over to Logan around 8:30 to complete our SOT homework and started class at 9 a.m.
I guess I was spent or overloaded, not sure exactly. I'm not sure exactly what happened but recall some of my thoughts and feelings. I know I'm tired of the constant driving. It's hard to find anyone that really understands that but I've been driving longer than most of my classmates have been alive. I guess the real thing that was getting to me was that I wasn't getting much out of my classes and it's no fault of the teachers, it's kind of a time crunch issue. My short term recall is in the tank. I'm having trouble taking notes. I'll hear something interesting and type a few words into my laptop then can't remember the rest of what they said. It's got to be related to exhaustion.

[3:30 a.m. - Sunday] The time demands are easier than when I tried pledging since I don't always have to get up at 3:45 or stay out so late but, current activities are getting close. When I was driving into Logan this morning, I had a similar feeling like right before I quit the fraternity pledging to try and salvage my classes.

[9:00 a.m.] For some reason I haven't been to sleep yet. I've laid down but, to no avail.
One thing I have learned and maybe this is especially true at my age is that sleep is vitally important. I know with the written comp board exam that falling asleep during the exam didn't provide very good results but taking it by itself and wide awake, it seemed like the easiest portion of boards. Holy Cow - I've got a graduation this coming Saturday. This is going to be an odd week. No class on Monday (Yahoo!), Board Reviews on Thursday and Friday then a graduation ceremony for the BS degree Logan students are able to pick up on their way to becoming a DC. I don't know about other people but I want to get used to walking across that stage and help visualize getting my DC! The following weekend starts my IHS program. I think that should be enough. It's only once a month for the next 7 months and ...assuming I'm really dropping my SOT class I'll have one extra weekend off prior to our Part II boards.

What can I say. I had a meltdown. I don't expect anything to get easier so it's vitally important I keep hitting the gym to be able to better withstand the demands of school. That portion of my life has really been going well. There's only been two missed days since finding out about my St. Peters clinic assignment. One of those days is when I was fighting to stay awake on my ride home from school and the second time was yesterday. I came home and slept until 5 p.m. I figured there's been enough stress and a day without additional physical stress may indicated.

[10:00 a.m.] I'm reminded of a quote I have on my facebook page by T.S. Eliot, "Only those who risk going too far can possibly find out how far they can go" I might be a little stressed about the long drives via the St. Peters clinic. I am being proactive and working out with cardio. I've also ate nothing but salads at school for lunch to help up my daily vegetable intake and avoid other less healthy options. I'm taking my vitamins ...I'm on the right track. I'm trying to keep my attitude on track and viewing the 2.5 hour daily trip as a very good quality problem to have. Which, it really is ...guess I'll have to wait and see how well I handle everything. About the only solid solution I could see to avoid the drive would be to drop out of school for a semester in order to sell my home and then move. I guess I could also try taking a standard (instead of accelerated) class load. Hell, with my luck, I'll sell my home to be closer to school and St. Peters and end up having to pick a new location!

Have I mentioned the utter stupidity associated with the current line of thinking regarding zero tolerance of swapping of office assignments with classmates? I'm also wondering more and more about the recent mandatory three-day per week office visits. I don't have any first hand experience with it but, from the people I've talked with that are already in St Peters it doesn't seem very popular. We've got three mandatory days, regardless of whether or not you have any patients scheduled and then the office meetings which may or may not fall on your clinic cay and then interns might have to come in on their non-clinic days if they do have patients scheduled.


Friday, February 18, 2011

Tri-7 Wk6 Day 427 - First Pediatric Patient!

Whew! I've been home less than an hour and we're already closing in on 11:30 p.m. which normally wouldn't be so bad on a Friday night but I have to be back at the Double Tree hotel tomorrow by 7 a.m. for Irene Gold then need to be back at Logan by 9 a.m. for my SOT class. Irene Gold is starting an hour earlier than normal and they're skipping the lunch break tomorrow to help get everything in and accommodate our teacher's return flight home to Arizona. That means when it's lunch time for SOT I can run back over to the Double Tree for another hour of Irene Gold Board Review. I'm not sure how long SOT will last tomorrow but, I'm hoping it's not any later than 5 p.m. I do have an assignment I need to finish up before I go to bed tonight.

So ...what happened today? Geriatrics was our first class. I'm glad I record that class because there's too much good information that comes at you too quickly to get any other way. Dr. Bub brought in his Pogo-Stick today and a few people tried it out. He sure has a way of making a point. I tried it in the hallway after class :)
Our next class was Activator! I finally got a chance to use my Activator tool on a patient. I swear to god that stuff is just AMAZING. Proprioceptive touch, mechanoreceptors ...it's just amazing that you can touch people in a certain spot and watch their legs even out. We use a special table in activator class which allows a person to go from their natural standing position onto a vertical table by simply leaning against it. We then press a button on the floor to lower the table and the foot piece the patient stands on. Once the table is flat and the patient is prone we compare leg length by holding the feet in a predetermined manner and compare the heels of the patient. There's almost always one leg showing that's shorter than the other. The legs are usually not uneven as a result of one leg actually being shorter than another but rather from the pelvis being rotated a little forward or a little back. We then touch four areas around the patients knee, and after each touch, we check the leg length again. We touch the medial part of the knees then the lateral parts of the knees. Usually, touching the medial part of the knee on the short leg side will cause feedback from the brain to cause the legs to become dead even. The evening up of the legs from a simple touch only last about a minute but, it tells us exactly where to adjust with our activator. It's really fascinating and I really need to learn much more about it.
Our Physical Therapy II class was next and we had a 20 question test. It was, literally, the same exact test he went over in class the day before but, even though we had all the answers I don't think there were too many people who actually scored 100% so they could skip the final next week. Having the answers ahead of time doesn't really do much good if there isn't sufficient time to get the material memorized. I admit, I had about 30 minutes last night after I got home and before I went to bed to look over material but figured that wasn't enough time to memorize all the material. At that point, nobody knew for sure that the review exam the teacher showed us in class was going to be the exact same test so I didn't bother with it and didn't worry about it.
This sort of makes me wonder about teaching philosophies. Had I known what we went over was going to be exactly what we were going to be tested on and if that test were handed out or somehow made available then I'm sure I would have gotten the thing memorized. The motivation and confidence level would have been high. I don't know but, if it's a set of fact we need to memorize then why not tell us exactly what you want. Seems like a lot more useful information would get memorized by more people. Just a thought.

My first afternoon patient was a little earlier than anticipated but things went well. I'm getting a lot of useful feedback from all the doctors on staff who go over our SOAP notes and diagnosis. With the trip and having to redo a part of comp boards this was only my 2nd full week in the student clinic so I think I'm doing alright. The first week or so I had to remind myself that it's not like I was getting whipped or anything but, it was all still a bit nerve racking. 726.12 is the IDC9 number one teacher wanted me to look up for Biceps Tendonitis and that same teacher also told me about a specific book he wanted me to get and to read the chapter on TMJ. Today, I got a lot of useful feedback on writing the S portion of my SOAP notes. The S stands for subjective and it's whatever the patient tells you but, I need to view it more as a history and have to be sure to ask the right questions to help elicit information from the patient necessary to treating them properly. I'm also getting a bit more used to the treatment plans and diagnosis. A few patients have commented that it seems a little rough but, the way I'm thinking is the only time I need to worry is when the teachers stop sharing information and guidance with me since that might be an indication that they've given up on me. So far, so good. :)

The surprise came around noon when I got a text from one of my patients asking if they could bring their infant daughter in to the clinic. We're talking a person scarcely over 1 year old. Kind of a scary proposition at first but, I sought out some of the best people I could find and Dr. Perillat said if I had them come in after 2:45 that she'd be be able to help me through it. The whole thing was rather amazing. I've got HIPPA regulation in the back of my mind but I believe the main thing is to not give out identifying information. On an academic level we can say that when an infant falls on their head that both the cervical and thoracic spine can become subluxated. The thoracic spine is kind of amazing on an infant. There usually isn't much vertebral body rotation but rather a dorsal or posterior movement of the vertebra which is quite obvious on an infant. Even a layman could run their fingers down the spine and tell when you've reached the vertebrae that's pushing out towards the back.

While we were waiting for the doctor I started taking a basic history. All I could think of at the time regarding examination was to check the cranial nerves. I figured the eyes were a good place to start and hoped to elicit some tracking of the eyes and responses to sounds. It sure was different looking into some absolutely huge, sparkling blue eyes of a child as opposed to the adults I've always worked with. The lateral tracking was good so I was able to confirm the abducens nerve (CN XI) was still functioning as it should and there was also response to sound. Dr. Perillat made the actual adjustments (thank god) and it was very interesting to note deviation of the gluteal fold, just as we had learned in class and in our books. There was also extension of the thighs and we could see the left leg go up higher than the right leg. When the right leg was lifted it would only go up so high then the pelvis would begin to tilt with the leg so we knew there was restriction or a subluxation in the right ilium. Once adjusted, the normal range of motion was restored.

One cool thing about working on an infant or, even an animal, for that matter is the fact that there isn't much in the way of a placebo effect. Either the adjustments work, or they don't.

OMG - it's well after midnight and i'm still up. I've got to get *some* sleep tonight. I may have to fill out my SOT homework tomorrow morning because these eyes are fading fast.

Thursday, February 17, 2011

Tri-7 Wk6 Day 426, continued

[9:45 p.m.] I did get out before 6 this morning and made it home about an hour ago.
A lot of my blogs contain tangents of thoughts. This morning's chat about a benefit of smoking was derived from an analogy pertaining to intestinal flora. Intestinal flora refers to the bacteria and "bugs" that live in the gastrointestinal tract. One benefit of having the normal, more innocuous bugs living in our GI tract is that it helps keep other, not so friendly, bugs from making a home in your gut. That line of thinking let me to the analog with smoking in that, like the normal flora, it's helped to keep out other, less friendly addictions from being able to gain a foothold in the first place. I'm pretty much spent. I'll have to make one more early morning tomorrow to get *some* time put in towards my Physical Therapy II quiz tomorrow.

Next week will be a bit odd. Clinic is closed on Monday due to the holiday and also closed on Thursday and Friday due to National Boards Part II review with NBS (National Boards Specialist).
It looks like Part II boards will be on the 18th and 19th of March, Friday and Saturday respectively. We have off on March 17th for final studying but ...that's a Thursday which is my clinic day. One of our EC's (educational coordinators) mentioned that day was a free-for-all should anybody want to schedule any patients but was unclear if those of us who had that day as their clinic day would still be able to have their room guaranteed to be available.

I did make it to the gym again on my way home from school. Can't say I really wanted to go there but, I did it and it was probably good for me. I just did five sets of leg presses, working up to 585 pounds for a dozen or so reps then hopped on a bike for 20 minutes. I think it has been easier waking up in the morning since i've been hitting the gym on a regular basis. My lunches are still salads and I've added a single broiled piece of chicken to top off the salad however, when I added the piece of chicken today I got a total of well over $11! yikes. Apparently, the chicken is $3.50 per piece. That seems a bit high to me. I have some protein type bars at home with about 20 grams of protein each and that should be plenty of protein for lunch and I still have about 1/2 a bottle of some fat free Thousand Island dressing so maybe I can lighten the lunch price up a bit.

I'm pounding down my third bottle of water now and will head to bed when it's finished. I think the breakfast I've been having at school has been improved a bit as well. They have a pretty good breakfast burrito at school. The improvement has been in having a class of fresh made orange juice instead of the soda I used to have when I first started at Logan. The freshly made stuff is only 75 cents to boot so that's a good deal :)

tonight/tomorrow:
sleep / study PT / Geriatrics / Activator / PT test / patient @ 12:30 / Irene Gold 3 to 8 p.m.

then a huge weekend of SOT which also contains homework and another exam ....oh crap. I just remembered I have another PT paper due tomorrow.

I'm not so sure about getting 100% on my PT exam tomorrow ....but, I'll still get through it.

MONDAY I'M OFF!!!!! :) no school, no clinic, no driving!

Tri-7 Wk6 Day 426, Thursday Morning

I think I first opened my eyes at 3:30 a.m. and the next time I opened my eyes it was 4:30. It's about quarter until 5 now and I've got my clinic attire in the wash machine and thought I'd knock a blog entry before I hit the shower.
I'm thinking my current "drug of choice" is pro-activity. There's nothing that's able to help me more than just jumping on things and taking action. PT exam is the big thing for tomorrow. Driving out to St Peters and home is the big thing for the future and I question how "random" our drawings were since I came in near last on our last three lottery drawings - speaking of which, I didn't win this weeks PowerBall lottery. ;)
I got a cool comment on yesterdays post from a recent graduate. They said they used http://www.chiro.org/LINKS/dx.shtml for clinic codes. I'll have to share that with the rest of my class. Huh, good site! Just transfered the codes over to a word document. Sounds like laundry is done - time to transfer to dryer and get some coffee. :)
[5:23 a.m.] snuck in a shower along w/ the coffee and laundry.

Someone posted a status update on Facebook saying there were over 1,000 chemicals in coffee but, I'm not sure what the point of the post was. Coffee is just a bean that comes from the ground and I would think the same thing could be said about any plant based thing we eat that comes from the ground.

Dr Bub kind of nailed a few things regarding some of the innate hypocrisy that tends to be prevalent at Logan when he commented on how there's so many people at the school who are ardent supporters of the all natural, holistic approach to health yet don't have a problem taking birth control or drinking alcohol on a regular basis. I'm thinking it's maybe a function of age or youth for people to by hypercritical of others without knowing much about the circumstances of another persons life. I was thinking about this a bit on the way home from school yesterday.

I do smoke but, there have been benefits from smoking. The biggest benefit I've gotten is realizing very early on that there are some things I cannot easily fully control and smoking would be one of those things. However, I've also been exposed to pretty much every single elicit drug out there from cocaine to heroin, ecstasy, pot, acid, crack, you name it, there's probably been a time in my life when I was exposed to it and it was available but, I've also known that if I can't handle the smoking, that is, if I can so easily become addicted to something as relatively innocuous as cigarettes then what are my chances of becoming really messed up and addicted to things that are presumably a heck of a lot stronger than cigarettes.

Anyway, those kinds of thoughts were always on my mind when I'd find myself around all that other stuff so I've stayed away from all the rest
...5:42 a.m. - hoping my clothes are dry - need to get moving. Leaving before 6 a.m. makes for a much nicer ride to school.
School / Patients / Workout / study for PT exam, that's my current future.

Wednesday, February 16, 2011

Tri-7 Wk6 Day 425, Wednesday

After 9 p.m. and I'm dead tired. GIUG didn't go as well as expected, I passed with a little cushion but not much. I'm hoping Geriatrics went a little better. It's odd, I was fine for about 1/2 hour after I got home then a huge wave of fatigue settled in. I did stop at the gym on my way home and put in 25 minutes of cardio. My Mobile WiFi unit stopped working yesterday so I got a new one from Best Buy and got that hooked up and running after I got home. I need to get to bed then get up early to finish up some laundry so I have clinic attire to wear tomorrow. I had tons of things I thought of on the way home that I was going to talk about but, I can't seem to stop yawning and just need some sleep. I'd say only two more days until the weekend but, it's another session of Irene Gold on Friday then two full days of SOT on Saturday and Sunday. I think I have another paper to write for PT due Friday and we just learned about a quiz we're going to have in PT this Friday. If we get 100% on the quiz then we don't have to take the midterm final next week. There's also an assignment due for SOT on Saturday and a quiz in SOT on Sunday. I know there's a bunch of stuff the following week but can't think of any of it at the moment. Still have every slot filled for tomorrow in terms of patients and also one on Friday so, that will make for 7 appointments this week. I still have two patients yet to see. Good night :)

Tuesday, February 15, 2011

Tri-7 Wk6 Day 424, Tuesday, Test & ICD-9

Knocked out our first GIUG exam today. Dr. Kuhn's exams are always interesting. The first 30 questions alternated between multiple choice and matching and the last 10 questions were all fill in the blank. No grades posted yet but I think I did pretty decent.

Yesterday's Endocrinology exam didn't seem to go as well. I have to figure something out with taking notes in that class. After almost three years at Logan I have a pretty well established system for taking notes on my laptop but, for some reason, we're not allowed to use any electronic devices in that class. My grades seem to be well correlated to the quantity & quality of my notes from class and, I just didn't have much for that class except some random pieces of paper I was able to scrounge up before class. It was a brief test, only 20 questions and only a little over half related to things I had studied. I think I know more than the grade will bear out. We'll see.

Tomorrow is our first Geriatrics exam. Wow - 11 p.m. already, I need to get to bed soon. I did make it to the gym tonight again and the place was packed.

I saw one patient today and have all of my available appointment slots maxed out for Thursday which is very cool! :) I liked the appointment I had today and things went well enough that I didn't feel like flushing my head down the toilet when I finished which, is always nice. It's kind of a huge transition going from books to people. I guess, like with studying, it can be an extra challenge to try to figure so much out on my own since I'm so far away from school that there isn't an over abundance of studying or interaction with people from school outside of regular class hours. Non-the-less, I have been able to pick up a few things from some of my classmates that should help. I was also thinking of spending some extra time with my patient's files to become more familiar with everything. One thing I'd like to do is compile a list of all the ICD-9 codes we're using for diagnosis.

ICD stands for International Classification of Diseases or, more completely perhaps, as the International Statistical Classification of Diseases and Related Health Problems.

Most of the world uses ICD-10 which was started in 1983 and completed in 1992 but Medicare and Medicaid claims have been using ICD-9 since 1988 so, that's what we still use today. ICD 11 is in the works.

Basically, ICD has a numerical number reference for every disease. ICD 10 contains more than 155,000 different codes. Starting with our class, we now have to enter in a code for every diagnosis.
This is great - I found an ICD-9 application for my iPad with a search feature and every single ICD code! :) 524.6, for example, is for temporomandibular joint disorders which, I've used today and now that I'm looking at my new iPad app, I'm thinking a code of 524.64 would have been a bit more accurate :) Oh well, I'm learning :) Wow, there's even a section for Procedures. 00.09 is for Ultrasound (which I did today also) :) Man, this looks like a great app, there's even a favorites section so all I have to do is compile a list of all the codes I've used recently, look them up and then put them in my favorites section for super easy access! :)

Tri-7 Wk6 Day 423, Monday

I was having trouble staying awake on my commute home from school so I figured hitting the gym was contraindicated and came straight home instead of stopping at the gym to work out. I wasn't home long when I crashed a little after 6 p.m. hence, the 1:30 a.m. wake up time on Tuesday morning. I just have to focus on today and get through it the best I can.
It's my non-clinic day but I still have a patient I'll be seeing at 4:15 p.m. so I need to get some laundry done and I've got my first GIUG exam today at 8:15 a.m.
These morning hours can slip by pretty quickly so I need to get moving. Laundry & studying is on the menu for breakfast :)

Sunday, February 13, 2011

Tri-7 Wk6 Day 422, Sunday & Irene Gold

Let's read for 40 minutes then get back to this blog.

Well, the reading turned into recording so I could listen to what I read on my way to school tomorrow and that just turned into studying.

Here is our teacher's website for our class. http://web.me.com/drges/Endocrinology/Intro.html

it's about 20 minutes until 1 - not sure if i should stay up later or wake up early ...
our exam is at 7:20 tomorrow.

I think getting to bed now and getting up as early as possible could be a good plan. Hopefully there will be people at school that can help me figure out some of the answers

btw, i did learn more about the clinic in St. Peters. When you have a patient all the docs & senior interns get together, complete with white board (just like on House, MD) to help you figure out the diagnosis. So, that's kinda cool :)

Saturday, February 12, 2011

Tri-7 Wk5+ Day 422, Saturday - Mom's Birthday :)

Not sure where to start but know I need to stay focused. Sleep is becoming a growing concern because I'm simply not getting enough of it. On the bright side, I at least get to sleep in until 6 on the weekends and don't have to leave home until 7 :)
It was another day of Irene Gold Board reviews today from 8 to 5 then I hit the gym again for my third day in a row ....that is, any day the gym happens to be open when I'm coming home for the night.
gotta focus ...
another full day of board reviews tomorrow.
Monday - Endocrine Exam
Tuesday - GIUG Exam
Wednesday - Geriatrics Exam & PT paper due
Thursday - probably a Reasearch Methods paper due
Friday - another PT paper due and more Irene Gold board review from 3 to 8
Saturday - SOT class (all day), quiz & homework due
Sunday - SOT class

also have patients on at least Tuesday, Wednesday & Thursday
and somehow ....according to an ambitious classmate who went out to the St. Peter's office I'm supposed to get out there by Feb 18th ...not sure where to fit that in. Possibly Wednesday but the last thing I really want to do is drive away from home then back home 50 miles through rush hour traffic.

I have to be pro-active about the clinic assignment. I'm getting in the workouts & cardio to help my situation.
Need to get hold of Mary S from class to order a new Activator. ....
....can't keep my eyes open anymore ...better get to sleep now before they end up shutting on my way back out to Chesterfield tomorrow ;)

Today's pic is of the family at my Mom's bday party :)


Friday, February 11, 2011

Tri-7 Wk5 Day 422, Friday - ChiroMission

kinda exhausted ...it's after midnight and I just got home about 40 minutes ago. Today was definitely interesting. Geriatrics is always informative then Activator class was downright amazing. It's literally almost like magic if you aren't aware of the neurology going on behind the scenes. For our third and fourth hour today we had a nice two hour lecture by Dr. Martin P Gallagher who is both an MD and DC which was absolutely fascinating. He was another one who advocated having chiropractors as the primary doctors seen before MDs. It makes a lot of sense both from a nonmaleficence (do no harm) point of view as well as from a fiduciary perspective. I know there was a state that delved into this and did save a great deal of money as well as providing excellent health care but ended up reverting back to the old health care model.

In one study that analyzed date from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two year period found that low back pain treated by a DC saves 40% on health care costs when compared with care initiated through an MD along with higher levels of patient satisfaction. It was a great talk by Dr. Gallagher and I wish I had my recorder with.

After the lecture I had to get recertified in CPR. I kept compressing too deep on the dummy hooked up to a computer so finally, the technician thought maybe I should try the CPR compressions with one hand. She'd never seen anyone do that before but it seemed to work out well.

Irene Gold National Board reviews came next, from 3 p.m. to 8 p.m. good stuff there as well. We mainly covered radiology tonight. After that I headed on over to Harpo's, a bar in Chesterfield, to help support a couple of classmates who are trying to raise money for a ChiroMission. They will be going to the Dominican Republic to offer health care for a 5 day period in March. Today's picture is of me with one of the ladies from my class that will be making the exciting journey. :)

One sobering part of the evening came during a break at the Irene Gold session when I talked with a fellow student who was doing his senior internship at the office out in St Peters. I know the upper tri students used to only do one day a week at their outpatient clinic and then that was bumped up to three days per week. I learned there are also weekly clinic meetings that need to be attended then heard from my classmate that they figured they would probably be at the clinic everyday. I'm not quite sure how well that's going to fly. Making that drive 5 days a week will mean about 600 miles of driving plus, I've got plenty of weekends booked with school related activities and classes. I could easily be looking at the equivalent of at least two good nights sleep in terms of the amount of time I'll be driving.

Tri-7 Wk5 Day 421 - Thursday & Rant

How far is as far away as possible? (pertaining to my St. Peters outpatient location). That would be a little over 117 miles. Home, to school, to St Peters and back home, a little over 117 miles. That last stint from St. Peters to home is an even 50 miles. kind of leaves me with a pervasively sick stomach.

Generally speaking, I'd say I'm getting pretty destroyed.
However, I have been taking arms against this current sea of troubles by stopping of at the gym on my way home from school. Ever since I found out about the St. Peters clinic assignment. I'm sure it's a fine clinic with fine people. It's my health or rapid degradation of said health that I'm most concerned with and I'd have to say that stems from my year of driving to school when highway 64 was closed down and my resting blood pressure skyrocketed by the end of that year. This drive to St. Peters is about 20 miles further then what I had to drive with the closed highway.

Of course, we do have two brothers in class that share one car who have been split up and one of them is at St. Peters. It might make a lot of sense to let me change places with the one that is not at St. Peters. That would solve two problems. For one thing, I would be spared driving 117 miles a day, three days a week for the next year and two, the brothers would both have transportation to their clinic. But, I guess ......yeah, i'll stop talking about it now ...for now ....

Today's pic is one of my new business cards.
I think I'm supposed to interact in the new location and maybe get those handed out...

I'm not so much bitter about the situation as I am confounded over the stupidity of the new policy which just took affect this trimester due to the actions of a previous trimester ...is that like throwing the whole family in jail because one member of the family did something wrong? Just as ludicrous, I'd say.

I think I could also make an argument for change when too many people who became chiropractors 20, 30 or even 40 years ago are in charge. They're just too far removed from the reality of what it takes to be a chiropractor these days. Some of those people making policy didn't go through half of what it takes to be a chiropractor today. Hell, a lot of the knowledge we learn today didn't even exist back then much less all the requirements that keep getting added.

What ever happened to that concept from the book, The Little Prince. I think that was the book. The concept was that sometimes perfection isn't attained when there's nothing left to add but rather sometimes perfection is achieved when there's nothing left to take away.

Wednesday, February 9, 2011

Tri-7 Wk5 Day 420 - St. Peters


We had our lottery today and I'm going to be out as far away from home as possible which means ...I wasn't very lucky with the lottery ;)

Oh yeah, I had a message sent to me from a reader of this blog. I believe it's the first message I've gotten so I'll do my best to answer it, here is the question from Marie

Why?

Scott, what motivated you to enter chiropractic at age 43?


Well, I entered at the age of 41 and will be graduating at the age of 45. Maybe it's from Helen Keller who said, "life is either a daring adventure, or nothing". The daring part was leaving a good job where I had 7 weeks vacation and great benefits not to mention the financial impact but ...why not? :)

The age aspect is pretty irrelevant to me. To me, I'll probably end up being 45 anyway so why not be a chiropractor when I reach that age or, whatever else I'd like to become?

When it got down to making the actual decision to leave my job and pursue this new adventure I ended up with a list of 26 reasons to make the move. I know I mentioned that 26 reason list in previous blogs but, don't always remember all of them. I know I've recalled some of those items since reading that question yesterday but ...heck, right now I don't remember which ones I remembered.

I know the reasons ranged from altruistic to pragmatic.

Some time ago, I read an article that stated by the time a person gets to be about my age (maybe a little younger) that there is a tendency to be doing what they wanted to do when they were 6 years old. When I was six, I wanted to either be an astronaut, doctor or magician and, probably in that order. So, there has been a long time interest in medicine and being a doctor.

I don't know, haven't you ever wanted to know all the stuff that a doctor knows? I have and maybe it's a thirst for knowledge but I definitely have not been disappointed with the vast amount of knowledge we've been taught.

There are definitely more reasons than I have time for right now. I just got a message from a fellow classmate that I'm working on a project with that's due tomorrow so I'll have to get to that.

Tomorrow morning is our Card Ceremony and my parents will be there. It's a little celebration for Tri-7 students who have passed their competency boards (including the OSCE!) and have become interns and entered clinic. :)
not sure what to put for the pic of the day ....let me take a look ...got it!

OK, now you're probably asking yourself why I would put up a picture of an eye with hyphema, aren't you? Well, it's because I ran across that word today in my reading and couldn't remember what it was so, it's kind of fortuitous that I came across it in one of my school folders. :)
Hyphema, btw is blood in the front area of the eye.

Tuesday, February 8, 2011

Tri-7 Wk5 Day 419 Tuesday & Class VI Certified :)

I can now use all the nifty LASER equipment in our Biofreeze lab for my patients. From what I've learned about how the K-Laser works on a biological level I was thinking it could be used successfully with fungal infections. I have a patient I want to try this with and have been putting together a protocol for it's usage and emailed K-Laser earlier today for any advice they may be able to offer. Then, ironically enough, on my drive home tonight I heard a commercial on the radio advertising for laser therapy for to fungus! It's a very common nail malady, #1 if I'm not mistaken so, if things go well, I'll have a happy patient and perhaps an extra nice little niche for a future practice. I'm looking at documenting the procedure and, if I get good results, maybe get something published.

I've been kind of amazed in our GIUG class. Today, we say a copy of an email sent by a doctor talking about one of his patients mother who had just started dialysis. The place where the lady was getting dialysis shared the fact that a full 1/3 of their dialysis patients are there as a result of using acetaminophen and NSAIDS!

Unreal. A third of dialysis patients due to misusing over the counter medications. Our class had heard a story the day before about a lady who was over using ibuprofen and was suffering from a sore back that she described as the worst back pain in her life. Upon examination the doctor (our teacher) noticed swelling in the ankles then paused with the impending adjustment to seek out a blood pressure cuff and stethoscope. His suspicions of high blood pressure was confirmed then he started asking the patient some questions and learned of her recent usage of ibuprofen. At first she was just taking a couple a day but then they weren't working quite as well and she kept upping the dosage. On the day she came in to see the doctor she had taken 24 ibuprofen over the course of the day. That's 4800 mg or 4.8 grams and was destroying her kidneys. The doc sent her to an MD who confirmed the diagnosis and gave her a loop diuretic which helped to alleviate the situation.

I guess the moral of those stories are that if you have to take an NSAID or acetaminophen to take the least amount possible and for the shortest amount of time. This all goes back to our pharmacology class and the discussion on COX1 and COX2.

Should be a fun week. I still have to recontact most all of my patients then put in 25 hours this weekend starting Friday at 3 for Irene Gold followed up quickly by exams on Monday and Tuesday in Endocrinology and GIUG, respectively. Studying for those exams is kind of straight forward. For Endocrinology simply know everything possible about the thyroid gland and for GIUG know all I can about the kidneys.

As far as internal health goes, and the post graduate Internal Health Specialty program I'll be starting in March, the kidneys and liver are probably two of the most important organs we have. The percentage of blood in the body that goes to those two organs alone is just shy of 50%. 27% will be found in the liver and 22% in the kidneys. Half our blood, right in the middle of our bodies. Knowing this, the test for jugular venous pressure from our physical diagnosis class makes a little more sense.

Today's pic is of my upgraded intern badge. The upgrade is that little sticker in the lower right hand corner with the Roman numeral IV. Which reminds me. We have a very nice breakfast presentation coming up this Thursday in the Purser Center at school. It's in honor of all the Tri-7's who have successfully completed their competency boards and have started clinic. Apparently the president of the school will be presenting each of us with our business cards as student doctors. And that reminds me of something else, once you have that intern badge, it seems to be common practice for people to start referring to you as "doctor" at least within the confines of our school which, is kind of cool. :)
My parents will be joining me in this Thursday's presentation. They haven't been to the campus since my brother went to school there back in the mid '90s. Then, they'll be making another trip there on the 26th of this month to go through a graduation for an additional bachelors degree that all students become eligible for after completing the first four trimesters at Logan.

Monday, February 7, 2011

Tri-7 Wk5 Day 418 Monday & a little late

My time off from school was extended a little bit today by missing my first hour class due to a crash on Hwy 64, not 5 miles away from my house, which closed four lanes and backed up traffic for about 90 minutes. Apparently a car swerved over two lanes and rear-ended a semi that was parked on the shoulder of the highway because of brake issues. It's not the worst accident I've seen on the highway but, referring to the picture, you can see it was pretty bad and I had my doubts that the driver survived. Later, I learned the driver was a 24 year old female from Belleville, IL who, in spite of injury, is still alive.

I need to get re-engaged with school at a very high level to make it through this semester. Usually, I'm pretty good at gauging what I need to do in order to be successful but with so many new aspects to this semester, such as clinic, I'm a bit clueless. I'm reminded now of an analogy I heard regarding how a car's headlights can only allow a person to see about 200 feet ahead but, even with that limited vision a car can still drive in the dark from LA to New York.

Tri-7 Wk4 Days 416 & 417, Fri & Sat - My Brother's Married!


These are two days were I wasn't actually in class but rather, in Las Vegas to participate in my Brother's wedding! :)
Amazing is the word that comes to mind the most to describe how everything went.

Today's pic will be one of many of my favorites from the wedding and I'll add a public link to look at the pictures I have posted on Facebook :)



Wednesday, February 2, 2011

Tri-7 Wk4 Day 415 - Snow & Vegas


School was cancelled this past Monday as of 3 p.m. as well as Tuesday and Wednesday of this week due to weather conditions. I'm not sure if I'll be going in tomorrow or just heading straight to the airport with my parents. Ideally, we would have a snow delay so there wouldn't be any worries about missing my first two classes.

... need to insert an 8 hour lapse in writing here. Heading to Las Vegas tomorrow!

Pic for today is where I'll be at tomorrow night! :) Minus 5 Ice Bar at Mandalay Bay, Las Vegas, NV! :)