11th Day of Vacation - DR. GRAYSON!

DC2B, Dr. Grayson will be starting Logan in January - AWESOME!

Feel free to contact me - Our classrooms are going to be right next to each other! Tri-1 is in classroom G48 and I'll be in G49.

TIP #1:

You'll be in the Auditorium on your first day at Logan - I'd suggest sitting in the back and here's why - when you and your class leaves the auditorium, you'll all head to your classroom and where you sit when you first get in your class room is pretty much where you'll spend the rest of your time at Logan. At the end of each trimester, you'll get a chance to change seats but you can only move to a seat that someone else moves from. So, if you sit towards the back of the auditorium then you can be one of the first ones out of the door and be more likely to get to sit where you want in G48.

Click on the link! --> Class Schedule

You'll find your schedule, as well as everybody elses, with that link.

Click on the link! --> Past Test & Notes for Tri-1

It's a Tri-1 Google Group, complete with PONYS (stands for Pass On to Next Year). Basically, a bunch of old test from Tri-1 to help you study.

The Classes:

If you look at your schedule and the projected student count for each class you'll notice a different number of students for each class. There's a projection of 90 students in Professional Development and up to 105 students for Biochemistry

BIOCHEMISTRY -

The teacher, Dr. Gutweiler, is fantastic and a favorite among many students which is nice because along with Gross Anatomy, biochem has the highest failure rate in Tri-1.

I have a biochem binder you're welcome to copy. Usually, people take this binder to Kinkos to get copied. The more copies you get made the cheaper it is per copy.

The past test are fantastic IF you look up each answer in your class notes or tutor notes. It's kind of rare to ever see the same question twice so it's really important to understand the material.

The 10% of students with the lowest grades get an F for this class and must retake it. Hence, it's the largest class you'll have.

GROSS ANATOMY -

Dr. Jan Clifford - nickname, dura mater, which means Tough Mother. Learn everything she has to teach and there isn't a doctor in the world you won't be able to stand toe to toe with. During the 2nd half of the semester many students said they spent 90% of their time studying for this class alone.

Study for the weekly quizzes as if they were test.

SPINAL ANATOMY -

Dr. Ludwinski - DO NOT UNDERESTIMATE THIS CLASS. At the beginning everyone seems to get the impression if you just complete the study guides and memorize what's in them you'll be fine. It's a tough class and you can see for yourself that Spinal Anatomy has the 3rd most students which makes it the 3rd most failed class in Tri-1.

HISTOLOGY/CELL BIOLOGY

These are actually two different classes taught by two different teachers. I don't remember the name of the lady who teaches Histology, I just remember her as attractive and very nice. Her class is kind of a relief. You'll basically need to memorize slides of various cells. It's not too much work to get A's on all the test in Histology. Looking back, it's interesting how much you'll keep hearing and learning about all the cells you learn about in histology.

Cell Biology is taught by Dr. Anand who is an extremely nice teacher and will refer to you as "Dr" from day one. He started teaching in the early 70's and his teaching style can be difficult for some but there are those who found his classes easy. You'll get a lot of handouts in his class. Maybe typing them out, since most are handwritten, can be useful.

PHILOSOPHY I -

You'll start to learn the history and more of the old-school concepts behind chiropractic with Dr. Hillgartner. If I'm not mistaken, the PONYs tend to be useful for this class

SPINAL ANALYSIS -

Dr. Bozark & several other DC's will help you with this class. With this class you'll literally get your first hands on experience with fellow students who will act as patients. If you attend all these classes then it's a pretty easy A.

PROFESSIONAL DEVELOPMENT -

This is a pass or fail class. You MUST attend every class or you don't get a P for pass. Very easy, just show up. There will be people other than the teacher come in to give talks and the people from other departments in the school are probably good to become familiar with.

For me, Tri-1 was OK until midterms, then it felt like a giant wave had crashed over my head. I guess I wasn't doing enough work up until that point.

Congratulations, best of luck and I look forward to meeting you. :)

32/32

In Tri-3, I attempted to complete 32 credit hours worth of classes which took up 34 hours per week of time and I earned all 32 credits by passing all my classes. I even did a bit better than passing and attained a grade of a B+ in three of my classes! :)

Keep in mind that a grade of 92% at this school is still just a B+, whereas in most undergrad schools such a grade would be well in the A range.

Here is a preview of coming attractions for TRI-4

1. Basic Nutrition
2. Physiology III
3. Pathology II
4. Professional Development
5. Philosophy IV
6. Orthopedics II
7. Diversified Technique III
8. Basic Technique II
9. Neuromusculoskeletal Diagnosis
10. Fundamentals of Diagnostic Imaging

That's it. Neuromusculoskeletal Diagnosis is abbreviated NMS and diagnosis is usually Dx. With basic technique we'll be needing to press on the sacrotuberous ligament which means the pants/shorts will need to be pulled down pretty far in order to hit that ligament. I've actually been more and more interested in the Basic technique since learning about all the positive results that have been obtained with pregnant women. A lady from our class was actually part of one of the studies in which pregnant ladies had basic technique performed during the course of their pregnancy and she did find favorable results. One consequence of pregnancy is a "waddle" in the walk which is due to the various joints being locked up in the pelvic region. Anyway, it seems to be a very worthwhile technique. I believe the fundamentals of Diagnostic Imaging will include taking x-rays for the first time. That should be fun. :) Fun-Di is how the class is usually referred to. I think that's the class where you can start out with 4 extra credit points --- actually may be 4% points worth of extra credit if you don't miss a single class. You lose one point (or percentage) for each day missed.

Nice, Positive Points about TRI-4,

• only 3 labs - the finals for labs are usually while we still are in class full time - can be stressful.
• Hwy 40 is OPEN - that means about 45 minutes or so less per DAY of time spent in my car - close to 5 extra hours a week!!!
• only 31 hours of class per week - a savings of 3 hours per week over tri-3

So, about 8 hours a week extra time - that's an entire letter grade :)

Not sure what to put for a pic - not sure how much I'll blog here again before our first day of class on Wednesday, January 13th. I kind of need to let everything settle down.

Tri-3, Wk15, Day 200! Thursday - 16/16

2:30 a.m. - less than 6 hours before this Trimester is over -

FUZZY (or maybe it was WOOLY) that was an adjective used in a matching section of our microbiology final exam yesterday! Who uses such subjective adjectives to describe something as scientific as microbiology. Apparently, that adjective was used to describe B-lymphocytes. OMG!

Two students asked the teacher to match up the last section of 5 matching which included things like Fuzzy and the teacher wasn't sure about the first two - oh well, another reason to be glad to be done with that particular class.

Have to study up for the orthopedics test coming up in less than 5 hours now -

I still need to see grades posted for 4 more classes before putting this semester in the bag -

Embryology - (got an A on that final yesterday)

physiology - took wed morning - pending outcome - certainly passed but am hoping I didn't hurt my grade any w/ the final -

Microbiology - probably last grade to be posted

Orthopedics - taking final in 5 hours -

OK - study time.

Tri-3, Wk15, Day 199 - Wednesday - 15/15

Three finals left.

Microbiology was the big test today -

With a 102% average in Philosophy, I blew studying off for that test completely and focused my attention on Micro -

I did look at philosophy the 1/2 hour before the test and I did give up my A and ended up with a B+ in the class but it was the right decision because I just passed by Micro test with 4 questions to spare -

I ended up with a 72% on my Micro final. I knew it was close while taking the test. It's a bit surreal to be in the situation of actually taking a final and knowing that if you don't get enough questions correct that you'll be left behind, that you won't make it fully into the next trimester with the class you started with.

It's a little after 3 a.m. and I still need to look at stuff for my physiology class - that final is in less than six hours -

I figured out the numbers and only need a 29% to pass the class but need at least a D on the final to maintain my C in the class - I guess it's still theoretically possible to get less than a 29%, fail the class and be held back so I shouldn't be so lackadaisical. I guess I'm just not sure where to start because there's so much information. We had 6 exams over the course of the semester in that class.

I've been looking over my embryo flashcards a bit - the first 12 are the toughest cards because the words don't really relate or stick to anything in my brain. There's a series of arches, clefts and pouches that relate to an embryo and we have to know what each one ends up becoming. For instance, the first pharangeal arch gives rise to the sphenomandicular ligament. I'm getting there but it's slow going.

We have our class picture tomorrow, taken by yours truly. That's at 11 a.m.

I CANNOT WAIT TO BE DONE WITH THIS TRIMESTER!

All I could think of for a picture was to show some bloodied soldier still standing - the pic of the day is as close as I could get w/o spending too much time on the search. The soldier in the pic isn't bloodied but is still walking which is a pretty good metaphor as well.

Tri-3, Wk15, Day 198 - Tuesday

got about an hour and a half sleep last night and got moving again at 1 a.m. this morning - it's about ...wow - it's almost 4 a.m.! I really need to get moving -

I thik I'm going to have another cup of coffee then hit the shower and head up to school.

I'm tempted to forgo looking at much philosophy because my grade is so high in that class - over 100% but, it's tough to flush an A down the toilet -

the tradeoff is more time to study microbiology - and as much above 100% as I am in philosophy is about as much above a D I am in micro.

thinking myabe I can replace my new 42 minute commute each day with two 42 minute walks during my break - I really need it

Physio is still a concern but, after crunching the numbers, I learned I can pass the class with a 27% on the final and get a C out of hte class even if I get a D on teh final.

I'm going to rock embryo - already made up the flashcards - simple case of memorizing my 61 flashcards and i'll get an A on the final - hopefully - well, either a B+ or A in that class.

I haven't seen my grade in Diversified yet but with the 88% i got on the practical, I only needed 20% on the final to pass and hopefully, I did a little better than that so I don't hurt my GPA.

I still have a lot of studying to do - I hope the 8 hours of studying to get a D on a physio test still applies to final exams - not sure. I'll have to sleep after I get home from Micro today then just stay up the balance of the day/night for my physio test at 9 a.m. on Wednesday - then keep staying awake to memomrize my 61 falshards for embryo -

Ortho is at 7:30 a.m. on Thursday - (double checking grade in orther)....

OK - sitting at 90% in that class - so, 25% on that final is all I need to pass - and, of course, well - I think a 93% or mmmm - 93 or 94% is needed for an A -

looks like a B on final means B in class - high A on final means A in class -

OK - so ...Looks like Microbiology Final Exam is the only thing that could hold me back -

geez ...just need more time - wondering about that wehn I got my coffee - thing is - new material is learned up until the end - then take each thign/test one at a time - study for one, then the next and so on - guess i needed to do more in the months preceeding to help solidify things -

have to do better next tri - not really an option since the load keeps increasing - alsmist like - do better just to maintain

I just have to improve more thatn the difficulty of the program - i can do that - somehow -

4:04 a.m. - need to shower and get out of here and on the road by 4:30 -

at school by 5:15 a.m.

read over philosophy notes - got about 50 pages or so of type written notes - say, 30 min on philosophy -

5:45 - 6:45 microbiology

6:45 - 7:15 - philosophy -

.,..if i do nothing for philosophy, i'll still be ok w/ that class - ok=C?

have to pass micro - still NEW stuff to learn for micro - got new material and new handouts right up until the last class of the last day -

tempted to put up a picture of praying hands again - no time - gotta run -

I thihnk... if this micro test is like the others then I'll be given a sheet to copy my answers to and then be able to check my score right after taking the test - Holy cow - so - around noon today I'll be grading my test and that should show whether I passed all lmy classes or not because Micro is the last hurdle -

Tri-3, Wk15, Day 197+, Monday (cont) 5/5

Public Health & Basic Technique I are in the book and give me a total of 5 credit hours earned out the the 32 credit hours attempted. So far - 5/5.

Another final grade came in for my Orthopedics Lab Practical and, amazingly enough, I ended up with a 38/40 so all that's left with that class is the written final on Thursday morning.

Final exams I took today for Diversified II and Pathology have not been posted yet. Some parts of pathology I rocked and a few other parts I was a bit clueless. The new stuff we went over I did rather well at - maybe only missing one on Neoplasia (cancer)

The first page of the Diversified written final was a bit of a bear. All four questions were on atypical vertebral rotation which isn't actually talked about in our book. I'll have to get that stuff figured out. I think I did well enough that I shouldn't have to worry about passing at all and there's a decent chance I raised my grade by a letter.

Tomorrow is Philosophy and I've got that 102% going into the final which is nice.

Microbiology is imperative, of the utmost importance and absolutely a must ... any failure on tomorrows test would mean saying goodbye to staying with the class.

If I could only stay up for three nights in a row then I'd have this thing in the bag.

Micro & Physio are HUGE -

I have a strong B in embryology but I'd like to think I could knock that grade up to an A if I really knocked the final out of the park.

Orthopedics - the teacher saved me on that one with the practical - I owe him. He's kind of an amazing individual and someone I liked before ever taking his class. With him, I've got a lot left to prove.

Philosophy, Microbiology //

Physiology, Embryology //

Orthopedics ...

then I'm done. .....

Today's picture is from the 2007 Pikes Peak marathon - I was there, I did the Ascent -

Starting at over a mile above sea level and transcending to an altitude around 14,000+ feet to the top of Pikes Peak; I hiked, jogged & walked to the top in 9 hours, 2 minutes.

It was hard. About like Logan.

Tri-3, Wk15, Day 197, Monday

Definitely a time crunch w/ school. I slept in until 4:30 this morning. Our first final isn't until 9 a.m. and a little extra sleep probably isn't a bad way to start the last week of Tri-3. I woke up wondering what I could have done differently to allocate my time but I don't think there's much different I could have done except w/ Sat night. Cutting back to two hours w/ family or maybe getting things pushed off a week it about it. Once I get through this trimester I'll work at doing more to make Tri-4 more productive. That's pretty much an imperative.

I really have to get some physio in today - I can pass that class, even get a decent grade (which I already have) but, w/o the time put in my grade could easily drop.

Today - Diversified at 9 - Pathology at 2.

Sunday Studies ...

got 200 flashcards made up for pathology but only through about 150 of them - this is where the time I spent away from home last night is starting to dig in and become real ...no doubt I'm going to take a hit on a grade - hope it's not physio.

still have diversified to get prepped for tomorrows 9 a.m. test and it looks like physio won't be touched tonight ...not good.

4 more days -

actually 3 days and a couple hours on Thursday morning. I'm dead tired and need to get to bed.

Saturday Studying, Mon will be day 197

Saturday was a pretty good study day up until about 5:30 p.m. I finished my micro lab paper by noon then made up flashcards and went through test for both Diversified and Pathology.

I stayed about 6 hours at my parents house to help celebrate my brother's 40th birthday. I think for 2010 & 2011 I'd like that celebration pushed off one week so I can get through my finals first, either that or not stay as long. I've just got to get back into the study mode.

As it stands now, I need 20% on the diversified final and 51% on the Pathology final tomorrow to pass both of those classes - unfortunately just passing doesn't help give a GPA high enough to qualify for taking National Boards. I'll have to wait and see how all the grades pan out.

I'll need some time today, Monday, Tuesday and very early Wednesday for physio - my grade in that class is most directly related to quantity of studying.

....planning my studying ....

- MONDAY -

I've got 200 new test questions and answers to get memorized for Pathology - need to make 176 more flashcards - no problem ...It's never a problem when I know exactly what to do because I'm already putting in the time

Diversified - we get to use our book on this final but, you've really got to know your stuff and exactly where everything is located. I need to get this done/prepped by tonight so it's all readily reviewable tomorrow morning before the test.

Microbiology Lab Paper - already done and it looks nice - worth 100 points!

- TUESDAY -

Philosophy III - I'll be darned - I've got 51/50 in that class ...a 102% average! I did skip the last hour and missed out on one of the extra credit points but got the 8 others that were available via pop quizzes. Heck - not bad! :) Well, it looks like whatever grade I get on the final will be my final grade for the class - maybe an 86% or above will give me an !

Microbiology - I'll have a good three hours before this test to hook up with classmates and study for this final - that's worth a letter grade right there. Monday night will be devoted to Micro/ Philosophy & Physio

OTHER - get paper handed in to Dr. for volunteer work done last week at the St. Louis Science Center. (professional development class)

Sunday Studying -

Pathology - 200 flashcards memorized (5 hours)

Diversified - get book labled & ready, go over all flashcards (2 hours)

Physio - go through old test, already made flashcards & powerpoints (2 hours)

Embryo - spend one hour getting questions & answers into FlashMyBrain program (1 hour)

Monday Studying -

a.m. hours - Diversified

after diversified - Pathology

after path final -

Philosophy - work on review sheet, look for any & all past test & notes

Microbiology - get handouts organized, flashmybrain cards,

Physio - work on review sheets, & same as above

Embryo - 30 minutes - add to flashcards or review what's done

Tuesday Studying -

early morning philo study, micro from 8 to 11:30 a.m.

Physio & Embryo - balance of day and late into the night

Wednesday -

early morning Physio study & then Embryo until 2 p.m.

ALL Orthopedics for the balance of the day and ALL night if necessary - Ortho is a 7:30 a.m. class on Thursday -

Thursday -

You better not even be going to sleep on Wednesday night - just keep moving - drink all the coffee, soda, mountain dew, 5 hour energy drinks necessary - just get through this - study as if your life depended on it -

take the last final at 7:30 a.m. - probably be done by 8 or 8:30 *then* sleep.

Bookstore - Buy whatever books are necessary for Tri-4 before leaving Logan on Thursday.

If money has come in from the last IRA I've cashed out then I can maybe go visit Grandma for a few days - Vacation - bring laptop, external hard drive, get computer prepped for Tri-4.

I like to call today's picture - strategic planning.

Tri-3, Wk14, Day 196+ Two Offensive Blows!

Very solid grades today in Basic & Public Health - 82% in Basic - 86% in Public Health!

Today's pic is of two tanks firing on their opponent. (can't really think of school as the enemy ...just a very formidable opponent)

OK, make that three tanks :)

I'm going to stay up as long as I can now and knock out as much as I can of a five page Microbiology paper that's due on Monday.

Next week is interesting and kind of nice. We've got two final exams each day for the first three days and a single final on Thursday to wrap up the semester. On each of the first three days we have very formidable final along with a regularly formidable final.

Monday, December 14th - Pathology & Diversified. Pathology is going to be tough. I have to learn all the new stuff we went over in the past week along with a thorough review of everything else we learned in the semester. I'll have three hours between my first test, Diversified at 9 a.m. and my path test at 2 p.m. I need 8 hours of study to get a D ....I'm thinking maybe 4 hours on each day this weekend - Sat & Sunday along w/ the 3 on Monday and I'd like an hour each day this weekend for Diversified along w/ the a.m. studying..

That's all the further I'm going to look at today. I need to get started on my Micro paper so I'll have time for all the other necessary studying.

I did get all my national boards papers completed today --- money order, passport photo, notorized, typed out application and submitted to the registrars office in time.

Irene Gold, NBS & NCBE are all covered now for Tri-4.

Tri-3, Wk14, Day 196, Friday

Went to bed around 10 last night and got up a little before 1 a.m. It was good to get a little shuteye.

I've been working on Basic and Public Health. I think I'm going to take off by 4 a.m. and go to a restaurant close to school and study until 6 then head to the cafeteria at school.

I need this break coming up like never before. I heard yesterday that Tri-4 has 1 more hour than tri-3 which would mean 35 hours per week of classes. Good physical condition is rather essential to success in a program like this -

I have noticed a reduction in the pitting edema which first took hold during tri-1. Undoubtedly, this is a positive result from my decreased commute time since the main highway to school opened up.

I'm still not sure if I'm going to make it through all my classes but will be finding out soon - I guess by this time next week.

I now believe living closer to school would have benefits beyond just more study time. I think stress levels would be reduced with more people around that are going through the same thing. There's an instant rapport and everybody understands the concerns and many are going through similar experiences.

With extra time yesterday I was able to talk more with fellow classmates. One guy said he dropped pathology after the second test because his scores were so low he couldn't come back and he wanted to salvage his remaining classes ...again, it's just a time issue. Another girl I talked with was very concerned with Public Health because she had failed the first two test.

Lately, I've been considering breaking up next trimester and taking two trimesters to complete it to get myself back in shape, both physically and mentally.

I'll have to wait and see how my brain is doing in a week or two but, I may have to look into the option further with my advisor to weigh the pros and cons of such an action.

As much as I have been struggling with all the stress, there's still a certain appeal to the major challenge that Tri-4 holds. Except for maybe 2 weekends, it's going to literally be 7 day per week schooling through the March, when the National Boards testing occurs.

I'm thinking I should probably take advantage of one of those offers to stay with somebody on Friday nights since the Irene Gold prep classes won't be getting done until 8 and the Saturday sessions start at 8 a.m.

Today's picture is called Cold_Steel_Chinese_War_Sword.

I still have 9 Final Exams, 1 paper and 5 days of school left to fight through.

I'm beat up but not dead.

Yesterdays blog may have seemed a bit melancholy but, I do want to provide a sense of realism to the blog for anyone reading it who may be considering doing anything similar with their lives. I also wrote yesterdays blog immediately after my Ortho practical which gave it an extra boost of emotion.

Well, it's after 3:30 so I better get a moving.

Tri-3, Wk14, Day 195, Thursday

I've gotten the shit beat out of me this trimester. I'm pretty much knocked and on the mat with eyes swollen shut. About all I've got going right now is my heart is still beating.

Tri-3, Wk14, Day 194, Wednesday

did pretty well on today's micro test. I went to the first half of philosophy this morning but wasn't able to study sufficiently so I left for the second half. I also opted out of my Basic class and was able to get in an extra 3 hours of studying that way. I'm close to an A in philosophy and close to not passing in Micro so I thought it was a good move and having seen my grade for the test today in micro it was the right decision.

For some reason we had our micro lab final during our lunch hour which left me about 10 minutes to eat. I stayed for the first hour of physio then had enough with everything and left ...there'a little more to it than that but I don't feel like bitching over what's done and over with.

Ortho is the big dog tomorrow. I have a solid grade in that class and, with another ungodly late night tonight and getting up at some insane hour of the morning tomorrow I should be able to maintain that solid grade ....I hope.

Friday is another big day - We've got Finals in Basic and Public Health. I'm counting on Basic to be memorization because that's what I'm going to be doing for that class. Public Health is a little more of a crap shoot. I'll be staying up all night tomorrow night to be ready for it - it's the last test we'll be taking for that class so it's totally going to be a pass or fail situation -

I'll have three hours between my first final and the public health final and I'm figuring studying with other people for 3 hours should be like studying for 6 hours alone, maybe another 8 hours tomorrow night and then use the balance of my time memorizing things for Basic.

Today's picture is something I found on the internet called "Hell on Earth"

Tri-3, Wk 14, Day 193, Tuesday

To be 20 years younger and live 45 miles closer to school...

It's 2:51 a.m. and I've got to get moving.

We've got our Microbiology Lab Final today at 11 o'clock which is usually our lunch hour. We voted the first time to take our exam during lunch to get it over with and get out of school a little early but that plan never worked to my advantage much - doesn't matter, that's when it is.

I'm getting destroyed physically. Only 3 days left this week and 4 next week - Hwy 40 opened back up this week so no more detour to school - I made it to school yesterday in 42 minutes!!! Even coming home yesterday with the rain I made it home in under an hour - I needed that.

My heart started racing at inappropriate times yesterday ...like, when I was walking - and nothing is going to get easier next trimester -

I'd already calculated that I'll be going to school 52 out of the first 56 days of school next semester due to all the weekend study for national boards via the Irene Gold reviews.

Yesterday I saw there are also NBR or National Board Reviews put on my Logan and some kind of Spinal Bootcamp that is going to eat up another weekend in February

If I do make it through all my classes this semester then I'll ......ugh

Need to get to my micro -

Orthopedics Final tomorrow -

Public Health and Basic Finals on Friday ...

Tri-3, Wk14, Day 192, Monday Rocked Path Exam!

Rocked out the path exam with an 85%! Yeehaw! That one test gave me enough of a cushion that I only need a 44% or better on the final to get through that class.

I stayed after school today and got some extra help with Diversified. I tend to think my learning curve could be about doubled with other people to work and study with. Let's see how things are stacking up...

Tue - Diversified, I still have more studying to do tonight but I did learn we're only going to be tested on Lumbar adjustments. For tonight, Diversified will be my focus. Tomorrows practical makes up 50% of our final grade. Well, I'll do everything I can. Except for some print outs I'm not sure I'll need my computer for anything regarding diversified unless I can find some YouTube videos on adjusting. I'll need to get 48 out of my next 70 points - 50 are available from the practical tomorrow and another 20 from our written final exam.

Wed - Microbiology II Lab FINAL - Basically, I'll need to learn everything for this class on Tuesday night as well as put together my lab book to be graded. We still have to do a 4 page typed write up for our unknown.

Thur - Orthopedics Lab Practical FINAL - I'm not sure what's up with this class - Like micro lab, I'll have to learn everything on Wednesday night.

Friday - Logan Basic FINAL - We aren't getting our review sheet until Wednesday and, like a lot of the other classes - we're still learning NEW MATERIAL which has to be learned along with everything else we've covered this trimester. Yikes!

Public Health FINAL - 2nd final for Friday. All I can say is I'll be drinking a lot of coffee on Thursday night and doing all I can to be ready for these two test.

That's all I want to look at for now. Next week, we'll have four more days of class and 7 more final exams. I'll need every second I can spare to do as much as possible to get through everything.

Let me look at those classes again ...

• Diversified - if i put in the effort tonight - good chance i can pull it out
• Micro - the lab paper is supposed to help our grade - maybe not much sleep tomorrow night while I prep for Micro lab final.
• Ortho - I'll have to learn a ton for this exam/practical. We have this class tomorrow so I'll learn more then.
• Public Health & Basic - these two are kind of easy, I'll just be up all night Thursday studying for them

The class with the least amount of margin for error is Micro - on the cusp with that one - There have been no curves to any of the test this trimester. OK, off to learn Diversified.

Sunday Evening Post...

9 days left of Tri-3. Our last day of finals will coincide with our 200th class day at Logan.

In my mind, I keep floating around the 50% chance of moving on to the next trimester which, essentially means, "I don't know". My prediction has nothing to do with confidence or anything like that, it's much more pragmatic and simply based on time. I know I can learn pretty much anything set before me but, I can only learn so much so fast. I was figuring today that say for physiology if I study 8 hours I can earn a D, 16 hours gives me a C and 24 hours studying gives me a B. For a class like pathology it might be 9 hours for a D and 18 hours for a C and I'm thinking I maybe got 20 or so hours in for our last exam so I think I can count on getting at least a C on our last test (we'll find out tomorrow)

I'm guessing those times would be less if I had other people to study with on a regular basis. It's a bit hard picking everything up on your own. I guess a main reason my diversified class grade is hurting so much is because the focus was on getting the time in for other classes. On our final grades webpage, labs and lectures are combined so I've got 10 classes to pass.

I'd really like to find out what happens to the $835 spent on upcoming prep and National Boards testing if I don't get through all of my classes. It's a tough hit to take financially when all you've got for income is student loans and a bit more stressful when it occurs just before Christmas and need to be buying gifts for the family.

I've used a dozen books to help prop up my coffee table in the living room to act as an adjusting table and have been practicing on my model spine.

...regarding physiology - My grade was on the cusp of a B before last test, then I took a hit and it dropped a bit. I could be taking another hit tomorrow and would need a solid showing on the final with at least a passing grade to get through that class. Anything less than a C though and that hurts the GPA and anything less than a C average would also prohibit me from taking boards. I think I'm well above 2.5, maybe 2.7 or so but it's still early in the curriculum and physio is a 6 hour class.

Diversified is on Tuesday - I thought of tutoring tomorrow during lunch but the physio test is right after lunch so I'll probably be cramming the last bit of info in my head for that ...I'll fit in what time I can.

Microbiology Lab Exam is on Wednesday - guess that's what I'll be studying on Tuesday night

Orthopedics Lab practical is on Thursday - I probably have as much to get down for that class as I do for diversified but, my grade is much stronger so I have a little bit of wiggle room

Friday is Basic and Public Health - Public Health is a bit of a problem for a lot of people. I kind of wish we could just get a booklet of fact and just memorize it. Things seem a bit random on that class but, I'll do what I can. I'll find out more this week what's up for Basic. Friday is the official start of our final exams so, we only have to attend our test. I think Fridays exams start at 7:30 and 11:30 so, I might make it home by 3 or 4 that day ....I'm quite certain I'll be looking forward to sleep when I get home :)

Monday is our Diversified written final along with our Pathology final. I really could use more time for both test...

Tuesday is Philosophy and Microbiology. I have a pretty strong grade in philosophy which means I'll probably put minimal effort into studying for that class and maximum effort studying for Microbiology which hasn't been such a strong class. For some reason, our teacher hasn't curved any of our test which is different than any other time we've had this teacher. I'm passing the class but not with any great cushion or leeway for any mistakes.

Wednesday is Physiology and Embryology - wow ....well, physio will probably be one of the most challenging exams I'll have and Embryo just takes the time to study to get a good grade.

Thursday wraps up tri 3 and our 200th day of class with our Orthopedics written exam.

I think it's going to be a series of naps throughout this week until I can get a good nights rest on Friday night.

Today's pic is of a coin being flipped! :)

I'll do my best. I know I can do better and improve some of my processes and habits for next time. I think I'm going to try a 90 min nap, then study from 12 to 2 then get another 3 hours sleep until 5 - heck, maybe until 5:30! then drink massive amounts of coffee and cram all the physio in my head that I can before our test at 1.

Tri-3, Wk13, Day 191, Friday, Little Blue Dots

Today was pretty fascinating overall. We started in on Chapter 6 in Pathology which covers Neoplasia which most people might refer to as cancer. A lot of words aren't meaning what they used to. Terms and phrases which used to be part of my everyday lexicon now seem vague and without meaning or don't make much sense anymore. Take the notion of a heart attack for instance. That doesn't really mean anything in a medical sense and I see more comfort in thinking of it in terms of infarction, ischemia and necrosis. I think terminology change first happened in gross anatomy when I started to wonder what an ankle was. I'm familiar with a lateral and medial malleolus but am no longer sure exactly what an ankle refers to, in particular, which side of the leg, medial or lateral?

Anyway - Todays pic of the day is from my microbiology lab class and those are my fingers holding a petri dish I was using in class to help determine an unknown bacteria. Two classes ago, I did a gram staining of my unknown and found it to be a gram positive cocci. Gram positive kind of just means it was blue under the microscope and cocci refers to its shape or morphology which happens to be like little dots. I figured I had a staphylococcus type of bacterium and to help narrow down which type of staph we were dealing with I put some of my unknown in the middle of a blood agar petri dish to see if my unknown would eat the blood or not. :)

Well, it did. The bacterium is in the center of the dish and you can notice clear areas around the bacterium where the blood agar is being consumed. Technically, this is known as beta hemolytic and the great part about that is I could then conclude that I was working with staph aureus! :)

That means I don't have to go to lab next Tuesday because I've already figured out what I have! :)

Heck, i just remembered I have that volunteer thing tomorrow at the St. Louis Science Center. I've got a ton of studying to do. Physio exam on Monday along with my diversified practical.

It's make or break time in Diversified. Based on my midterm performance, I won't pass the class so I've really got to pull out something good on Monday or I won't move on to Tri-4. If any class is failed then you don't move forward ...at least not as fast as you otherwise could. We won't think about that possibility for now.

Tri-3, Wk13, Days 189 & 190, Wed & Thur

My attitude has been rather lackluster lately. For most of today I've just been thinking I want to get off this Merry-go-round. I want it to stop, I want this to be over. Normally, I don't think I'd blog such despair but I also realize that one reason I wanted to complete the program at Logan and become a DC was that such completion would necessarily force me to become a better person and I have learned throughout my life that it usually works best if I am in a situation where I'm forced to improve and that's certainly where I find myself now... forced to improve.

Metaphorically speaking, I feel like I'm clinging to a buoy out in the ocean and clinging for dear life, just waiting for the 17th of December to come save me and hope that I don't ingest too much sea water & drown before being rescued.

Anyway, blogging the truth about how I feel can serve as a baseline for where I'm at right now and, hopefully, (ideally?) I won't be downtrodden with so much despair in future trimesters.

I've got three classes which could sink me - Pathology, Diversified & Microbiology. Tomorrow I have an opportunity to gain some ground with Pathology and I feel like I should get no lower than a C on tomorrow's test which would be fantastic. Micro is kind of in the middle - it will sink me if I fail either of the remaining two test or don't pass the lab portion of the class. My Diversified final practical is on Monday so I still have time to mount some kind of defense and hopefully get my grade up a notch or two.

I could really use some people to practice on for Orthopedics this weekend.

OK, what's new with pathology? I'm still going over Immunity stuff here and I think I've got down some of the immune deficiency diseases

• XLA, Brunton's dz - the XLA stands for X-linked agammaglobulinemia which seems like a mouthful until you break it down a bit - recall the 'a' stands for "without" so, we're without gamma globulin in the blood - the emia part always seems to refer to blood. The disease makes a bit more sense w/ a picture (guess I'm a visual type learner) but, the B cells never quite make it out of the bone marrow with this disease which is why you don't find much of their consequences out in the blood.
• CVI - (or CVID) - Common Variable Immunodeficiency dz - with this dz the B cells make it out of the bone marrow but not much further. Instead of agammaglobulinemia we have hypogammaglobulinemia. which is to say instead of without that stuff, we have hypo or low gamma globulin in the blood.
• Isolated IgA Deficiency - this is the most common of the immunological deficiency diseases and occurs in about 1 out of 600 people and it's asymptomatic - ...there's that letter 'a' at the beginning of the word again so, it literally means "without symptoms".
• DiGeorge or Thymic hypoplasia - this is a defect in the thymus gland itself and that's where T cells grow up to become adult T cells.
• SCIDS - Severe Combined Immunodeficiency - This is really bad. Do you remember that show, the Boy in the Bubble? I think John Travolta may have played that little kid in the bubble. With this dz, the stem cells with the potential to be either B or T cells is thwarted at the very beginning.

....OK, I've got 1 week to get everything submitted for Part I of National Boards. I learned today that the $510 fee for those test has to be paid by a money order. I have no idea what the policy is if I don't pass all my classes in Tri-3.

I do know, assuming I pass everything, that I'll be going to Logan for 19 days in a row to begin my fourth trimester because the Irene Gold study sessions are from 3-8 p.m. on Friday and from 8 a.m. to 5 p.m. on Sat & Sunday. Then, I'll have two days off then another 12 days in a row because of the third study session. I did work out the issue of getting my application filled out and printed properly so now I just need to get a photo taken in our Media department at school then get the money order so I can submit everything to the registrars office.

To be licensed, a chiropractor needs to pass a series of four national boards test along with physiotheraphy. The areas to be tested in Part I include General Anatomy, Embryology, Spinal Anatomy, Physiology, Chemistry, Pathology, Microbiology and Public Health

Tri-3, Wk13, Day 188 - Tuesday

Our Pathology teacher is in the hospital so we didn't have that class this morning and after going back to bed I overslept a bit and started my day off with physiology at noon followed by microbiology lab, micro lecture and then our professional development class.

We're going to have a paper we have to write for micro lab that will be due sometime next week. I also got confirmation today on my volunteer hours for this Saturday, and I'm on for the 2 to 4:30 shift so I'll hit the physio tutoring review at noon (I think it's at noon) then head over to the Science Center to put in my time.

At this point, I'm kind of just holding on and riding out the storm.

I did get some one on one time with one of the Dr's from the Health Clinic today and she said they have an MD they work with who is close to school and will do office visits for $25. I've got some issues I'd like to get answered and resolved.

7 days of regular class before finals

5 days of finals

total of 13 more test & one paper

1 volunteer day

NBCE application submitted w/ photo

Tri-3, Wk13, Day 187 - Monday

Holy you know what ...

where to start.... Well, for whatever reason the test that had been scheduled for well over a week had some people wanting the test changed and at the last minute (ie today) our class voted to change the test to Friday. I don't agree with the last minute change. Not everyone was available to vote and many people had already made sacrifices to take the test tomorrow - it's kind of screwing me up but guess it's something to deal with. As a class officer, I might shoot out an email suggesting last minute changes not be made anymore - certainly not with less than 24 hours before a test. And, of course, we have another physio test coming up - also this Friday or perhaps the following Mon.

Irene Gold Prep payments were due today for National Boards and I got that taken care of. I've also been working on the actual application for National boards online but had some problems w/ the system and submitted an email to the NBCE for help. The application for National Boards is kind of like submitting for a passport, right down to the picture which must be submitted w/ the application.

We have a review for our physio final exam scheduled for this coming Saturday at noon or 1 ...dang it - I just submitted a volunteer request with Barnes Jewish Hospital and requested midday on Saturday ...guess I'll have to change that....

Also, on Monday is another review for the physio final to be held at the Double Tree hotel close to school from 3 to 5 p.m.

And, of course, much of my future plans are predicated on successful completion of Tri-3. Assuming I get through that, here's what's going on and when...

• 12/01 Tue - Irene Gold NBCE prep $ due
• 12/03 Thur - Pathology review @ 4
• 12/04 Fri - Pathology Exam 4
• 12/05 Sat - Physio Final review at Logan
• 12/06 Sun - Volunteer w/ BJC at St. Louis Science Center
• 12/07 Mon - Physio Exam 5 and Diversified Practical and physio final review at Double Tree
• 12/08 Tue -
• 12/09 Wed - Microbiology Lab Exam
• 12/10 Thur - Orthopedics Final Practical
• 12/11 Fri - Basic I Final & Public Health Final and NBCE application due
• 12/14 Mon - Diversified Final and Pathology Final
• 12/15 Tue - Philosophy Final and Microbiology Final
• 12/16 Wed - Physiology II Final & Embryo Final
• 12/17 Thur - Orthopedics Final

Tri-4 should start on Jan 12th, which is a Tuesday. That coming Fri, Sat & Sunday on Jan 15, 16 & 17 we'll have NBCE study reviews and we'll have more study reviews the following Fri, Sat & Sunday. Then again in February on the 12th, 13th & 14th we'll have NBCE reviews again then we'll have until the NBCE reviews at Logan to keep studying. During the week before we actually take the boards, our classes will be replaced with school sponsored review sessions every day leading up to our actual testing.

For anyone reading this that's starting at Logan this January, you'll be in the same boat I'm in and will need to have an extra $835 next December to cover the cost of prep & testing fees for Part I of the National Boards.

I guess I'll publish this post then stare at my blog and try to come up w/ a plan for tackling everything that's coming up.

Pathology I: Immune System

I've got another picture from the book helping me out and will post it as today's pic of the day. The analogy I gave yesterday about the inner workings of the General Motors plant being messed with has more to do with a viral infection, when a virus overtakes the inner workings of a cell. This is known as Cellular Immunity, sometimes referred to as cell-mediated immunity.

Cellular Immunity is a type of adaptive immunity. When this happens the infected cell somewhat literally puts up red flags which poke out of the membrane of the cell which help tag the cell for destruction.

When it comes to protecting our system against foreign invaders we may consider two types of cells, B cells and T cells. These are two types of cells collectively known as Lymphocytes and are sometimes referred to as B Lymphocytes and T Lymphocytes.

They get their designation (B or T) based on where they grow up.

Cells that mature in the Bone marrow are called B cells

Cells that mature in the Tymus are called T cells

T-Cells are the cells that notice the red flags on the buildings and from what I've gathered, these red flags are literally pieces of protein derived from whatever virus has infected the cell.

With my GM analogy, we said that instructions were rewritten to replace the gas pedals with bubble gum. When someone inside the cell (or building) noticed this they took a piece of that bubble gum and stuck it out on the roof of the building as sort of a bubble gum flag and the ever present T-Lymphocytes (T cells) would notice the aberration and bring to light a host of fighters known as effector cells which would then destroy the building all together.

What are Effector Cells? The names of the cells that will destroy the building, so called because their ultimate effect is destruction of the building, the ultimate effect of the immune system.

Anyway, that's some of how it works with T-cells. T-cells deal with the cells in our body that have themselves been infected.

But, what if a microbe such as bacteria doesn't infect a cell but just causes problems outside of the cell. In our ongoing analogy this would be like vandals spray painting the side of the GM building or littering on the grounds or something like that.

Sometimes the police need help in distinguishing the good guys from the bad guys so, in order to be able to put the vandals in the police cars, the bad guys are tagged with antibodies. For whatever reason, the can't get bacterial microbes in their cars unless they are first tagged with an antibody.

In the accompanying picture, this scenario is on the left side of the picture under the heading of Humoral Immunity and Humoral Immunity is what the B cells do.

I'm going to have to fast-forward and get to learning the diseases associated with various aspects of the immune system. I'd like to learn everything well enough that I can talk about it and explain it myself but with so many classes that isn't always an option.

I need to pay attention to some of my other classes. Diversified would be a good one.

Out of all the lymphocytes in our bodies, B cells make up about 10-20% of lymphocytes while the T cells make up about 60-70% of our lymphocytes (Natural Killer cells make up an additional 10-15%)

Pathology I: Immune System

ADCC, Antibody-Dependent Cell-Mediated Cytotoxicity. It's enough to make you cry after countless hours trying to study something only vaguely familiar however, the picture on slide 106 of our pathology power point presentation shows a picture of ADCC and a few elements of confused gases swirling around in my brain have begun to form into something that makes sense based on that picture. I'll post the picture as today's pic of the day.

The human immune system is based on a system of surveillance operating on the simple principle of distinguishing "self" from "non-self" In other words, we have a variety of "soldier cells" capable of destroying other cells and pathogens (foreign bodies) but, these soldiers which protect us need to be able to tell the good guys from the bad guys.

Take a close look at that picture. In it we see the cell in the upper left labeled as a Target cell. Now, this Target would be the bad guy which needs to be taken out BUT - that target very well may have been one of us, a good guy that's gone over to the dark side and now needs to be taken out. In this sense, we come to realize that an individual cell has been infected by some foreign invader, be it H1N1, or even the Aids virus. When a cell is taken over by a hostile (i.e., foreign invader) it may burrow down to the core of the cell and take over the protein processing factory in the cell which we may refer to as the nucleus of the cell.

As an analogy, let's say the nucleus of General Motors is an assembly plant to make cars and a foreign invader comes in and rewrites some of the instructions for making those cars. Let's say instead of using hard plastic for the gas pedals the invader rewrites the instructions to use chewed bubble gum instead of hard plastic for those gas pedals. Then, when those cars are released into the rest of the world and are driving on our highways there are going to be problems.

Basically, whatever was supposed to be produced in that nucleus isn't being properly produced anymore. Heck, maybe instead of cars being produced things might be rewritten to manufacture horse & buggy carriages which again will mess things up by clogging up the highways.

The thing is, when a normal cell from the human body is taken over then there may be tell tale signs that the cell has been compromised. If you look at the picture again, you'll notice spikes protruding out of the membrane of the cell. Now, notice the little black "Y" shaped things floating around in the picture. Those are antibodies. In fact, those are antibodies which are specific to the spikes sticking out of the compromised (Target) cell. The cell at the right side of the picture shows the target cell with the antibodies attached to the spikes of the target cell and THIS is how the cell is labeled for destruction.

The cell at the bottom most portion of the picture is labeled an NK cell. NK stands for Natural Killer and the NK cell has receptor type locks on it's membrane which fit to those particular antibodies. Think of a lock and key. The antibody may be the key and the receptor on the NK cell may be thought of as the lock. When that antibody key clicks w/ the Natural Killer cell lock then the NK cell may take action to destroy the Target cell.

hmmmm.....

That's one way NK cells are able to identify the bad guys in the human body but, how do they know which cells to pass over?

Almost every cell in the human body has what are known as Class I MHC molecules on the surface of their cells and Killer cells have an inhibitory receptor on the surface of their cells which fits with the Class I MHC molecules. Again, we have another key & lock scenario. When the inhibitory receptor lock meets with a Class I MHC key then the Killer cell knows those cells are part of us and moves on.

I think of the movie The Ten Commandments with Charlton Heston as Moses (can you believe that was made in 1956?!) Anyway, during part of that movie there was some kind of plague destined to go through the town and kill children or something but, houses which had blood on the door were passed over by the plague. I'm not sure how accurate I have the movie but, those Class I MHC molecules are like the blood on the door - Killer Cells just pass them by.

ADCC - that's where we started this conversation and remember the AD stands for Antibody dependent. From what I'm understanding immunoglobulins are another type of antibody ...immunoglobulins are designated IgG, IgM, IgA, IgE & IgD.

When it comes to IgG, in particular, I'm thinking of how the military can light up targets with a laser so overhead airplanes can drop bombs on the target. IgG can coat bad cells and there are receptors on Natural Killer cells that can recognize an IgG coating. These receptors are called CD16 & Fc receptors.

CD16? What does the CD stand for? Good question, I don't know. Let me Google it...

That was worthwhile, it looks like CD stands for Clusters of Differentiation :)

here is a link to wikipedia with an incomplete list of 300 or so differend CD molecules.

http://en.wikipedia.org/wiki/List_of_human_clusters_of_differentiation

Talk of CD molecules, which help differentiate cells, are found on the surface or membrane of our cells. There are a few we've covered in class...

CD3 is a molecular complex used for cells to identify T-Lymphocytes which make up about 60-70 percent of the lymphocytes in our blood. Each T cell is genetically programmed to recognize certain membrane bound antigens. So far, I've presupposed antigens can be good or bad depending on whether they are recognized by the body or not as "self" or "non-self" Wikipedia mentions the word Antigen as coming from "antibody generation" which may or may not be true but, it's something to hang my hat on for now.

CD3 is a series of molecules that help relay information into a cell once a T-Cell has connected to an antigen binding site on the cell.

For now and in general - I'm relating things as follows ...

CD3 - T lymphocytes

CD4 - helper T cells

CD8 - T-suppressor or T-cytotoxic cells

CD16, CD56 & Fc go w/ Natural Killer Cells

CD 18+, CD19+, CD20+ go w/ B-Lymphocytes

then we need to recall that with helper T cells there are two subpopulations

T-helper-1

T-helper-2

and, I need to have those associated with things.

Namely,

T-helper-1 goes w/ Interleukin-2 (IL-2) and Interferon gamma (IFN-g)

T-helper-2 goes w/ Interleukin 4 & 5 (IL-4 and IL-5)

Then, we need to get back to the various markers on the regular cells of the body, at least that's where I think the following classes of molecules are found.

We mentioned MHC molecules earlier. MHC stands for Major Histocompatibility complex or for humans, we may also say (or use) HLA which stands for Human Leukocyte Antigen.

We have three classes of MHC -

Class I MHC consist of

HLA-A

HLA-B

HLA-C

and, of course, there are subpopulations of those things

Class II MHC consist of

HLA-DP

HLA-DQ

HLA-DR

or, you might broadly say Class II is associated with D and class I is associated with A, B, C (for memory purposes anyway)

Class III has to do with components of the Complement system and here we associated C2 & C3 with Class III.

Pretty vague & a bit confusing, huh? I hear ya.

I guess a main thing to take away from all these HLA things is that they are markers found on cells and tissues in the human body and one of the most important thing having to do with these markers is in the area of transplants. Most folks are aware that people have different blood types and it's not good to randomly mix peoples blood types because bad things can happen if you do.

Well, it's not a good thing to mix HLA's either. The liver or kidney of one person will have a specific set of HLA markers in the cells which make up their liver or kidney and they can only get a transplant from a person who has similar HLA markers. To mix those markers up means rejection of the transplanted organ.

Also, there are some interesting correlations between different HLA markers and various diseases. For instance, a person with HLA-B27 has a 90 times greater risk of ending up with a disease known as Ankylosing Spondylitis. What is ankylosing spondylitis? I honestly don't know, at this point I just need to konw that HLA-B27 is associated with a 90 times greater risk of ending up with that disease.

Rheumatoid Arthritis is associated with HLA-DR4 and type 1 diabetes is associated with HLA-DR3 and HLA-DR4.

Wow - time flies when you're having fun. I need to take off in 15 minutes to meet my parents for lunch! :D

Thank god - I need a break and decompression time. ;)

Tri-3, Wk12, Days 185 & 186, Tue & Wed - Survival

Made it through those two test on Tuesday and figuring I'd end up taking a hit on my grades I focused a bit more on embryology to help hold the good grade I had in that class and took the hit more in physiology.

I had a nice 6 hour nap after school today and was watching House on my computer for a while afterwards. I'm going to get a couple pathology ponys punched into my Flash My Brain flashcard program and need to do likewise for embryology. Our final test seem to be set so it's just a matter of pulling through now. Wow - just posted what's coming up below and it seems like a lot. I think there will be a few more test before the final, I know we still have plenty of physio to cover and another test to get in for that class. I'm going to knock out some physio now.

Mon 11/30
Tue 12/1 Path Exam
Wed 12/2
Thur 12/3 Diversified Practical (B)
Fri 12/4

Mon 12/7 Diversified Practical (C)
Tue 12/8 Diversified Practical (A)
Wed 12/9 Microbiology Lab Exam at 11
Thur 12/10 Orthopedics Final Practical
Friday 12/11 Basic Final, Public Health Final

Mon 12/14 Diversified Final @ 9 a.m. 156B
Pathology Final @ 2 p.m. Purser
Tue 12/15 Philosophy Final @ 7 a..m.
Microbiology Final @ 11
Wed 12/16 Physiology II Final @ ? a.m.
Embryology Final @ ? a.m. in ?
Thur 12/17 Orthopedics Final @ 7?

Tri-3, Wk12, Day 184, Monday

We have two test scheduled for Tuesday; one in Embryo & one in Physio. We also have two fellow classmates who act as educational coordinators (EC's) for our class and I learned earlier that at least one of those EC's was able to take the embryo test on Monday. I can't help wondering if that person will be gone today or just got the embryo test knocked out so they could wholly focus on physio for Tuesday. I can't help thinking that would have been a fantastic option for everybody because we could have totally focused on studying embryo Sunday night then devote all of our attention to studying physio on Monday night.

Anyway, I'll be very curious to see if our EC is in class today. If they were leaving early for a vacation then it's understandable and I'd imagine they would have taken both test early.

Perhaps I'm just lamenting my own lack of preparation and really wish the test were split up. Still, I can use this as a learning opportunity. I could have easily focused on embryo Sun night and Physio Mon night ...didn't occur to me.

Either way - I'm going to take a hit in both of these classes. Fortunately, these are my two best classes so I do have a bit of a cushion.

It's about 5:22 a.m. and I'll be taking off by 5:30 to avoid traffic and get some extra studying in at the cafeteria.

One other note, I moved a good sized table to my second bedroom and will work at studying in there. I don't smoke in the house so, that will be a plus because it means extra time w/o smoking and perhaps better focus on my studies since I won't have the benefit of distraction that having a cigarette provides. Plus, I guess I'll get a titch more exercise since I'll have to get up and walk out into either the garage or outside to have a smoke. :)

Today's picture is of a rabbits foot. I guess I feel bad for the rabbit but certainly need the luck. I have to wonder if rabbits are actually used for anything other than their feet. I sure hope so. Maybe I'll find a different lucky charm to use next time. Actually, that line of thinking invokes a whole other article.

Pathology I: Immune System (Simple Outline)

What Happens When An Enemy Invades Your Body?

• THE IMMUNE SYSTEM
  
  • The purpose of the Immune System is defense and protection through a system of surveillance
    
  • This surveillance operates on the simple principal of distinguishing "self" from "non-self"
    

Outline Contents:
Effectors of the Immune System
Histocompatibility Genes
Immune Mechanisms
Autoimmune Disorders
Immunodeficiency Diseases

• EFFECTORS OF THE IMMUNE SYSTEM
  
  • Cells & Cytokins
    
  • T Lymphocytes
    
  • B Lymphocytes
    
  • Macrophages
    
  • Dendrtitic & Langerhans Cells
    
  • Natural Killer Cells
    
• T Lymphocytes
  
  • In the blood, T cells constitute 60 to 70% of peripheral lymphocytes
    
• B Lymphocytes
  
  • B lymphocytes constitute 10 to 20% of the circulating peripheral lymphocyte population
    
• MACROPHAGES
  
  • Macrophages play a major role in inflammation, but also have many activities in the immune response. (s28)
    
• Dendric & Langerhan's Cells
  
  • Dendritic cells are widely distributed. They are found in lymphoid tissue and in the interstitium of many nonlymphoid organs, such as the heart and lungs. Similar cells within the epidermis have been called Langerhans' cells (S31)
    
• Natural Killer (NK) Cells
  
  • Approximately 10 to 15% of the peripheral blood lymphocytes do not bear TCR or cell-surface immunoglobulins.
    
• HISTOCOMPATIBILITY GENES /Molecules
  
  • Originally identified as antigens that evoke rejection of transplanted organs, histocompatibility molecules are now extremely important for the induction and regulation of the immune response and for certain nonimmunologic functions (s39)
    
• Cytokines
  
  • The induction and regulation of the multiple immune responses involve multiple interactions among lymphocytes, monocytes, inflammatory cells (neutrophils) and endothelial cells.
    

  
  

• IMMUNE MECHANISM
  (S66)
  
  • Contact with antigen leads not only to induction of a protective immune response, but also to reactions that can be damaging to tissues
    
  • An antigen is a substance that can be specifically recognized by the immune system and cause a response
    
• Tissue Damage (Hypersenstivity) (s76)
  
  • Tissue-damaging immune reactions may be evoked not only by exogenous antigens, but also by those that are intrinsic to the body (endogenous) (s76)
    
• Type I Hypersensitivity (Anaphylactic Type)
  
  • A rapidly developing immunologic reaction occurring within minutes after the combination of an antigen with antibody bound to mast cells or basophils in individuals previously sensitized to the antigen.
    
• Type II Hypersensitivity (Antibody Dependent)
  
  • This type is mediated by antibodies directed toward antigens present on the surface of cells or other tissue components.
    
• Complement-Dependent Reactions
  
  • #1 – Antibody (IgM or IgG) reacts with an antigen present on the surface of the cell, causing activation of the complement system and resulting in the assembly of the membrane attack complex that disrupts membrane integrity by "drilling holes" through the lipid bilayer (s100)
    
  • #2 – Cells become susceptible to phagocytosis by fixation of antibody or C3b fragment to the cell surface (opsonization). (s101)
    
• Antibody-Dependent Cell-Mediated Cytotoxicity
  
  • This form of antibody-mediated cell injury does not involve fixation of complement but instead requires the cooperation of leukocytes.
    
• Antibody-Mediated Cellular Dysfunction
  
  • In some cases, antibodies directed against cell surface receptors impair or dysregulate function without causing cell injury or inflammation. (s107)
    
• Graves' disease
  
  • Graves' disease is the most common cause of hyperthyroidism
    
• Type III Hypersensitivity (Immune Complex–mediated)
  
  • These reaction are induced by antigen-antibody complexes that produce tissue damage as a result of their capacity to activate a variety of serum mediators, principally the complement system. (s114)
    
• Local Immune Complex Disease (Arthus Reaction)
  
  • The Arthus reaction is a localized area of tissue necrosis resulting from acute immune complex vasculitis, usually elicited in the skin 128
    
• Type IV Hypersensitivity (Cell-Mediated)
  
  • This type of hypersensitivity is initiated by specifically sensitized T lymphocytes, rather than by antibodies
    
• Summary of Immune Mechanisms
  
• Graft-versus-Host (GVH) Disease
  
  • GVH disease occurs when immunologically competent cells are transplanted into immunologically crippled recipients. GVH disease occurs most commonly in the setting of allogeneic bone marrow transplantation but may also follow transplantation of solid organs rich in lymphoid cells (e.g., the liver) or following transfusion of unirradiated blood 139
    
• AUTOIMMUNE DISEASES
  
  • Three requirements for autoimmunity:
    
• Immunologic Tolerance
  
  • Immunologic tolerance is a state in which the individual is incapable of developing an immune response to a specific antigen
    
• Clonal Deletion
  
  • This refers to loss of self-reactive T and B lymphocytes during their maturation
    
• Clonal Anergy
  
  • This refers to prolonged or irreversible functional inactivation of lymphocytes, induced by encounter with antigens under certain conditions 144
    
• Peripheral suppression by T cells
  
  • Many factors, both cellular and humoral, that can actively suppress autoreactive lymphocytes have been described.
    
• Mechanisms of Autoimmune Diseases
  
  • The pathogenesis of autoimmunity appears to involve immunologic, genetic, and viral factors interacting through complicated mechanisms that are poorly understood 147
    
• Bypass of Helper T Cell Tolerance
  
  • Tolerance may be broken if the need for helper T cells is bypassed
    
• Molecular Mimicry
  
  • Several infectious agents cross-react with human tissues through their haptenic determinants (B-cell epitopes)
    
• Polyclonal Lymphocyte Activation
  
  • Autoimmunity may occur if such self-reactive but anergic clones are stimulated by antigen-independent mechanisms 151
    
• Imbalance of Suppressor-Helper T-Cell Function
  
  • Any loss of suppressor T-cell function will contribute to autoimmunity, and, conversely, excessive T-cell help may drive B cells to extremely high levels of autoantibody production 152
    
• Emergence of a Sequestered Antigen
  
  • Any self-antigen that is completely sequestered during development is likely to be viewed as foreign if introduced into the circulation, and an immune response will develop.
    
• Consequences of the loss of self-tolerance: autoimmune diseases
  
  • Autoimmune diseases range from those in which the target is a single tissue, such as the autoimmune hemolytic anemias and thyroiditis, to those in which a host of self-antigens evoke a constellation of reactions against many organs and systems 154
    
• Systemic Lupus Erythematosus (SLE) 155
  
  • SLE is the a multisystem disease of autoimmune origin, characterized by a many autoantibodies, particularly antinuclear antibodies (ANAs).
    
• Sjögren's Syndrome
  
  • Sjögren's syndrome is characterized by dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) resulting from immunologically mediated destruction of the lacrimal and salivary glands. 159
    
• Systemic Sclerosis (Scleroderma)
  
  • Characterized by excessive fibrosis throughout the body. The skin is most commonly affected, but the gastrointestinal tract, kidneys, heart, muscles, and lungs also are frequently involved 162
    
• IMMUNOLOGIC DEFICIENCY SYNDROMES
  
  
  • Traditionally, immunodeficiency disorders are considered according to the primary component or components involved (i.e., the B cell, the T cell, the undifferentiated stem cell, or complement); however, in view of the extensive cell interactions between T and B lymphocytes and macrophages, these distinctions are not always clear-cut 167
    
• Expansion of Immunologic Deficiency Syndromes

Tri-3, Wk11, Day 183, Friday

This was a pretty bad week for attendance mainly due to illness. Emesis on Tuesday and made it to one class. Near emesis on Thursday and simply felt nauseous with movement.

Weekly Attendance, 62%

I've got an embryology & physio II test on Tuesday so I'll need to get moving on those things. Two labs are due Monday for physio so that will be a good place to start. We get credit for the labs as long as we turn them in on time so it's an easy 3/3 points per lab. You could write down "Mary had a little lamb" as answers to all the questions and still get credit but, they are invaluable (to me, anyway) when it comes to learning the material so I'll spend a few hours on those after I post this blog.

I have several outlines I've worked on for various classes and have been wanting to post the outlines but they are quite long and didn't finish either one prior to my test. I've got a new one now I'm working on for pathology. I'm making the outline from the powerpoint presentation which is 175 slides long. I'm through slide 134 which is about 20+ pages worth of outline. Once I get that initial outline done then I want to make a kind of contents for the outline to help me grasp everything better.

On to Renal! :)

Tri-3, Wk11, Days 180, 181, 182 - Tue, Wed, Thur

This will not be a good week for attendance. I've been feeling pretty rough. Right now, I'm just trying to avoid throwing up or, emesis as we say in school. :)

Current projections for getting through this semester are around 55%. I need to work at bolstering that self derived projection in a more positive direction.

Anyway, up a little later today than normal but, pulling an all-nighter for Wednesday's microbiology II exam isn't exactly normal either. I did pass my micro test and I'm passing Pathology which is my other tough class. But - I am passing. The other class I need to devote some extra attention to is my Diversified II or adjusting class.

I was getting ready for my 10:10 a.m. embryology class but each movement made me more nauseous so I've fallen a little behind in getting to that class today. I've still got Public Health & Physiology left for the day so I've got another little break until classes resume at noon.

My blood pressure has come down since Monday. systole dropped to 166 on Tue & in the 140s today. My diastole pressure was higher on Tuesday with 108 but today it's a much more appealing 80.

I can't help wondering if the time away from the stressor, i.e., school is what's allowed my bp to drop. I wonder if the resistance to school is part of the body's natural defense since it has had a profound positive effect on my bp.

I need to read over my Public Health notes for our test tomorrow while I have the time. Embryology & Physiology test are both next Tuesday then we have a half day next Wednesday and FOUR DAYS OFF!!!!

I need that time off like I've never needed time off before. I have to make good use of that time with plenty of studying otherwise the pressure will only continue to mount.

Tri-3, Wk11, Day 179 - Super HIGH BP

I could tell by the way I've been feeling and my agitation levels that my blood pressure was probably high but, I had no idea how high - I checked my blood pressure after I got home AND after just sitting still for a good 10-15 minutes it still read an astounding 212 over 106 with a heart rate of 95 bpm. No wonder I've been wanting to get my hands on some Valium lately!

More study & good grades could go a long way in easing tensions but, my current state isn't all that conducive to a high rate of retention. Non-the-less, we have a Micro test on Wednesday that I have to study for. There's a vaccine seminar tonight & I wish it was only 20 minutes long but I believe it's 2 hours long ....

There were a fair number of people that skipped this morning's Public Health class to study for our 2nd hour Pathology test. I went to my class. I'd like 100% attendance for the week so I have *something* to feel good about. :)

- Today's Class Summaries -

Public Health - We got a new handout on Healthy People 2010. Apparently, new goals are set every 10 years by Health & Human Services as to what our Nation should be striving for in terms of health. The US has never met any of the Healthy People goals.

Pathology - I'm on the bubble. I got about as low of a grade as I could while still passing. I thought I did a little better than my final grade reflected. Right now I'll give myself about a 60% chance of making it on to Tri-4

Diversified II - I just have a lot of work to do for this class & still need to catch the teacher to inquire about my midterm grade.

Basic I - We started with x-ray marking and the class was rather interesting. We learned how the x-ray machine needs to be dead on straight and not off to one side or the other. It reminded me of watching a baseball game. If the camera showing you the pitches is off to one side then you get a skewed view of the strike zone so, pitches that may actually be a ball might look like a strike from a perspective that isn't directly in front of or behind the catcher.

Anyway - the x-ray film needs to be centered with the tube and the tube needs to be centered with the "bucky". What the heck is a bucky? I don't know, haven't learned that yet. I'm not even sure if I'm spelling it correctly at this point. Also, the floor needs to be level as well.

Physiology II - We went through slides #7 through #33 today on our third Renal ppt.

I think I might almost like the extreme detail we go into in Physiology more than the somewhat more conceptual take we're getting in Pathology. For Pathology, it looks like it's enough to know that endocarditis & cardiomyopathy are predisposing factors for heart Thrombosis without actually knowing too much about endocarditis or cardiomyopathy. But, this is our first pathology class so I'm sure there's a lot of groundwork that needs to be laid before we delve into a lot of detail. For me, just having words without meaning makes it hard for me to memorize those words and make them mine. I'll figure something out - hopefully sooner rather than later.

It's time for Micro! Today's pic ...hmmm, let's look for a bucky!!!

looks like a Bucky is a device that moves the grid while an x-ray is being taken.

According to the caption - this pic is a Siemens X-ray bucky table Typ Multix TOP manufactured 1998.