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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

RIP Thomas.

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

Tri-9:

Week 8

Thur - 10/27, Day 561

Fri - 10/28, Day 562

Week 9

Mon - 10/31, Day 563

Tue - 11/1, Day 564

Wed - 11/2, Day 565

Thur - 11/3, Day 566

Fri - 11/4, Day 567

Week 10

Mon - 11/7, Day 568

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

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

Female Complaints

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

Male Complaints

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

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

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

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

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

Fibrocystic Breast Disease -

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

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

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

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

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

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

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

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

Graves - hyperthyroidism

Hashimoto - hypothyroidism (aka autoimmune thyroiditis)

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

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

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

Nausea and Vomiting of Pregnancy (NVP) -

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

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

Pelvic Inflammatory Disease -

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

Premenstrual Syndrome (PMS) -

• PMDD - Premenstrual dysphoric disorder
• Xenoestrogens - environmental estrogens

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

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

Primary Causes of Premenstrual Syndrome -

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

Physiologic Effects of an Increased Estrogen to Progesterone Ratio

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

Hormonal balancing with nutrition -

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

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.