TRI-6! TRI-6! Day335 TRI-6! TRI-6! Thur TRI-6! TRI-6! TRI-6!

TRI-6

If I die tomorrow just make sure TRI-6 is emblazoned upon my tombstone!

What a freakin' ride! I certainly can't think of any television show with as many twist, turns, challenges or ups and downs as this past Trimester.

T6 starts in 19 days.

plenty to get prepped & ready before then.

I got to be friends w/ Dr. Guebert last week as well as previously with Dr. Montgomery on Facebook. Dr. Guebert is a DC and a DACBR (board certified radiologist)

I'm pretty sure I can become a DC and have a good shot at being able to get into the Master's program after graduation. I've never really doubted myself about anything but, the one thing I would have doubts about is whether or not I could pull off the DACBR thing ...

DACBR takes three years of additional schooling after becoming a DC and that only entitles a person to take a test - passing and becoming a DACBR is not guaranteed ...just a chance to take the test ....

*Very* impressive accomplishment for those who have been able to pull it off! :)

TRI-5, Wk15, Days 333 & 334, Tue & Wed

We'll be ending this Trimester tomorrow on Day 335. This journey began 581 days ago and there's 612 days until it ends with our graduation on April 21st, 2012.

By the way, the days I'm counting in these blogs are the actual days of class. I was just curious about how many days one must go to school to become a chiropractor. Kind of like, "How many licks does it take to get to the center of a Tootsie Roll Tootsie Pop?"

I think it's Wednesday and my last bit of sleep was on Monday night (?) I don't think I'll be sleeping any tonight because I'm concerned if I fell asleep now that I might sleep through my last final. I tried laying down around 8:30 but I guess I'm just too wired.

GRADES - so far so good and there is *very* good news regarding the bulk of my grades.

My toughest class - Physical Diagnosis aka Phys Dx (pronounced "fizz - dye") has been conquered! Things really went down to the wire with that class. I had an A in the lab portion of the class but the lecture portion must be passed independently before the lab grade can be calculated in our final grade. I needed to get 19 answers correct on our final to pass and I ended up getting 22 correct! Thank god for the three extra credit questions.

This phys dx final, as well as many others, were much different than exams we've had in the past. For phys dx, every question was a case history of a patient and we had to diagnose them. The diseases ranged from Fibromyalgia to Huntington's Chorea.

I poured an enormous amount of effort into phys dx over the last week and I did take a hit (grade wise) in a few classes but not too bad overall.

Rad Pos & HCP were both maintained with a B+

I rocked Toxicology with a A

Lab Dx IMPROVED! I was able to bring that grade up to a B

Basic III should be interesting. The final grade isn't posted but, I severely underestimated that class and maybe overestimated Lab Dx a bit so I think my lofty B+ in Basic might get beat down to a C ....I certainly hope no worse.

Cardiorespiratory Dx - well, I waved by to the A I got in midterm several weeks ago. I have a hard time with Dr. Christy's exams but, I did get a 25 on the Final which is my 2nd highest test grade (best was a 26 on Exam 1) so, even though my grade will drop from the midterm A it's actually going to be increased from where it was after my third exam.

Diversified - I got a 17 out of 20 on the final for an extra 34 points and I only needed 17 points to pass that class so I'm golden there also :)

All I've got left is my Biomechanics final which is tomorrow morning at 7:30 a.m.

I wish I could know for sure that I could lay down for only an hour or two because I am dead tired but it's just too risky. With as little sleep as I've been going on there is a high probability that I'll stay zonked out for a good 10 hours ...I can't let that happen. There's only 8 hours until my last final at 7:30 a.m. tomorrow. I'm going to make a pot of coffee and make sure I stay awake - I'm going to do well on my final then come home and get to sleep! :)

Today's picture is of a cup of coffee :)

btw ~ I did get a nice photo album of various dysplasias and congenital anomalies to help w/ the Dx Imag class up on facebook. You can see the pics by clicking this link http://www.facebook.com/album.php?aid=71959&id=1324821250

Unfortunately ... it looks like the casualties are starting to roll in - so far I've got two study buddies who didn't make it through Dx Imaging ....dang

but - they did get through Phys Dx so we'll be able to study Phys Dx II together. I have heard some people say they've done better with Phys Dx II because they've learned how to study better and know more of what's expected after struggling w/ Phys Dx I. I'm hoping that's going to be the case for me.

However ...I just checked my schedule of classes for Tri-6 and there's 13 classes! Only 33 hours but 13 classes is a bunch to deal with just on an organizational and administrative level. What classes you ask? OK, this will be my last bit of fun then I've got to get cranking on my biomechanics studying ....

TRIMESTER 6 CLASSES:

1. Professional Development
2. Diversified Technique V
3. Prin. of Physical Therapy I/Therap Modal
4. Jurisprudence
5. Patient Communication Skills
6. Chiropractic Clinical Reasoning
7. Physical Diagnosis II
8. Physical Diagnosis II lab
9. Eyes, Ears, Nose and Throat Diagnosis (EENT)
10. Neurology
11. Pediatrics
12. Diagnostic Imaging II
13. 
    

TRI-5, Wk15, Day 332 - Dx Imag & Tox

I'm getting this blog in a day early. It's still Sunday night and I've spent the last 5 or 6 hours studying Physical Dx even though that exam isn't until Tuesday at 11:30 a.m. My plan is to get up tomorrow morning around 3ish and get to school early for my final preparation for the Diagnostic Imaging final at 9 a.m.

I'll study toxicology from about 11:30 to 1:45 ...not much time for tox study and I hate to give up that nice, strong A I have in that class but I can't afford to put much time in studying for a class that's so strong when others are much weaker. Still, my grade in tox is so high that even a 79% or better will still get me an A.

Tuesday is Rad Pos at 7:30 a.m. I'll get up early again for that one and cram in what I can. I've got a solid B+ in that class and just got a 97.5% on the final practical so pretty much any mediocre score will get me through that class - I'll get two hours of concentrated studying in before that class, from no later than 5:30 to 7:30.

Phys Dx - 11:30 a.m. Tuesday - this class is TOUGH! tons of stuff to remember. I've gone through 173 different flashcards tonight, many multiple times. 120 of those cards are on the eye with 18 on the fingernails and 35 pertaining to headaches.

Wednesday - 9 a.m. Diversified Final - I sure hope I don't get screwed in this class. I need to pass the final to pass the class. Everyone seems to be aware of laboratory test which can sometimes have false negatives and false positive results but nobody seems to think the same thing can happen with people giving subjective exams - i.e., practicals. Lab test can be flawed but, apparently, not the people who administer our practicals.

...got diverted w/ flashcards & facebook - time to get some sleep.

Today's pic is of a Nuclear Cataract which looks gray when seen by a flashlight. I have an online version of my Phycical Examination book and that's the picture that was up so I thought I'd use it! :)

TRI-5, Wk14, Days 329, 330, 331 - Wed, Thur, Fri

Let the odd sleep times begin! On Friday, we had 7:30 and 11:30 a.m. exams in Lab Dx & Basic III respectively. I don't remember when I fell asleep after getting home but I know I just woke up and it's 12:30 a.m. Saturday!

It looks like my first Final grade has been posted and I was able to raise my C (at midterm) in Laboratory Diagnosis from a C+ to a B! Yeehaw! :)

The Basic III final today kind of left me beaten & bloodied. I had a nice shiny B+ at midterm but I don't think I'll be left with that as a final grade. I thought I knew more or enough to do well in that test but hadn't brushed up on the x-ray marking and ended up falling asleep a couple times during the exam ....neither of which helped my grade, I'm sure.

Dr. Montgomery gave us a pretty cool final, it read kind of like a book or storyline in which you had to make decisions along the way in terms of answers to various questions and treatments for your patients. I could probably lament and reflect on that exam for a while but need to shift gears for our next upcoming exams.

Each day next week I have a bigger kind of exam along with a less significant one in terms of difficulty and/or need in terms of grade.

Monday is Dx Imaging at 9 a.m. and toxicology at 2 p.m. Dx Imaging is the most failed class of Trimester 5 but I managed a respectable C+ at Midterm and obviously would like to keep or maybe better that grade to a B if possible. The 2 p.m. test that day is Toxicology and even without the points of the final I've already managed pass the class. During the first three test in Toxicology I've missed less than one point per test and only need a 79% to get an A in that class. So, the focus for that day is Dx Imaging.

Tuesday is a little more crucial in terms of passing, especially with Physical Diagnosis, our 11:30 a.m exam. Our first exam that day is Radiographic positioning at 7:30 a.m. At Midterm I had a B+ and got an average of 97.5% on our Final Practical so, passing that class shouldn't be a problem ...keeping my B+ or getting better is much more of a challenge.

Wednesday is Diversified at 9 a.m. and Cardio Dx at 2. Again, I've already passed the Cardio Dx class and have to pass the diversified written final to pass that class.

Thursday is our Biomechanical final at 7:30 a.m. so, I'll just study all night if I have to for that exam and be done with the semester.

Physical Diagnosis is the 2nd most often failed class of Tri-5 and is proving to be a heck of a challenge for me. The studying for that class is a little different than I'm used to. The memorization is a little different and something I just have to get used to.

For Diagnostic Imaging (Dx Imag or Dx I) I'm going to upload photos to my Facebook account of different x-rays then tag some of my classmates to those pictures and hopefully a worthwhile dialogue for each picture will ensue.

Today's picture is the cover of the photo album I'm going to create on Facebook.

I somewhat regret that I haven't been able to share more interesting factoids about some of the things we've been learning this semester. One thing I'll share before getting back to studying is something I learned from Dr. Sanders in Lab Dx. He told us that the criteria for a surgery to be successful was to not leave the pt any worse off than when they started. So, nothing actually has to be fixed or corrected. Can you imagine if other businesses had the same criteria?

I guess it was a little more interesting when we heard about it in class with examples. Off to upload some skeletal pics now! :)

TRI-5, Wk14, Day 328 - Tuesday

It's time to pick and choose my battles. Yesterday my primary battle was with a Diversified practical and to most effectively deliver a knock out punch to Diversified I had to take one in the guy from my 3rd Cardio Dx Exam.

By the way, I also learned to be careful when telling your mother that you've "blown off an exam". I should probably rephrase to say, "I'm doing the best I can" and both of those statements would probably be equally true.

On Wednesday, my primary battle is with Rad Positioning, which means I'll be letting my guard down with a quiz we have in our Basic III class but, it's all part of an intelligent, thought out strategy that has served me well thus far. A classmate described the process in a Facebook comment by stating the classes you're doing well in get put on the back burner so more focus and effort can be put towards the classes where one isn't faring as well.

In undergrad, a student may take 18 hours of classes and is considered full time. I remember having to get special permission to take 21 hours. At Logan, 32-34 hours is the norm & people taking the masters program have closer to 40 hours. Heck, some people also take additional course work on the weekends for various specialties.

It's a different world and with a dozen classes in a semester strategy becomes eminently important.

Only two days left of regular classes before finals start. Our Basic quiz is 2nd hour on Wednesday and worth about 5% of our grade. The Rad Pos practical is at 3:30 p.m. and worth closer to 25% of our grade so, effort must be allocated accordingly.

TRI-5, Wk14, Day 327

kinda dazed - I got two hours of sleep last night and took a two hour nap when I got home. I think I'm going to sleep in until 3:30, maybe 4 o'clock this morning. I have to have my Diversified polished for our practical at 8:15 a.m.

Cardio Dx Exam 4 will be taking a back seat to Diversified but, after the diversified practical I'll study what I can before that exam.

We've got Radiology Positioning Practical on Wednesday as well as homework and a quiz in Basic III ...here Basic will take a bit of a back seat to the Rad Pos.

Thursday is a free day then two finals a day after that until next Thursday morning.

We studied pain some more in our pharmacology (aka toxicology) class today. I think most people have probably heard of COX inhibitors, maybe on TV or something. There are a few different types of COX - COX1, COX2 and COX3 ....maybe more

COX2 is kind of "bad" and contributes to pain. COX1 is kind of good and contributes to helping to maintain our gastric lining as well as smooth renal function.

First generation COX inhibitors are things like aspirin, acetaminophen and ibuprofen. Those medications can not discriminate between the good and bad COX so they block both of them which can provide relief from blocking the bad COX (COX2) but it also blocks the good (COX1) which helps to protect our stomach and keeps the kidneys running smoothly.

That's the reason we see the side effects about upseting the stomach.

2nd Generation COX inhibitors are a bit more selective and can block only COX2 but still don't seem to work quite as intended. Celebrex is the only one on the market now and the FDA issued a warning about it in 2005. The two other COX2 inhibitors were pulled from the market and include Vioxx (pulled in 2004) and Bextra which was pulled in 2005.

one other thing about COX1 (the "good" COX) is the it promotes platelet aggregation however inhibiting this action may be considered a benefit as it can provide protection against myocardial infarction (as with low dose aspirin)

We also talked about benzodiazepines. Take a look at the last part of that word, benzodiazepines. and you might recognize the generic name for valium, ie diazapam.

Valium (a type of bensodiazepine) is another drug that was in widespread use before we knew how it worked. The first benzodiazepine was discovered in 1955 and made available in 1960 but it wasn't until 1977 when researchers discovered a receptor in the brain specific for bensodiazepine compounds. Tylenol was the same way - wide spread use before we knew exactly how it worked.

Benzodiazepines like valium enhance the effects of GABA which is one of those chemicals our body makes to help calm the nervous system, which is to say it has an inhibitory effect.

GABA is one of those key players in chiropractic since it can be elicited by mechanoreceptors.

TRI-5, Wk13, Days 325 & 326 - Thur & Fri

Wow, I didn't realize I'd missed two days last week. I went to the Lake of the Ozarks right after class on Friday. We had a guest speaker for HCP, a man by the name of Dr. Nelson. It was a very interesting chat and I really like one part he said. I've kind of been paraphrasing and reworking what he said - here's what I've got so far;

I know the secret to life is movement

The older you get the less you move

The absense of motion is called death

and another thing I've come to understand is the slower you go, the faster you die

so the amount of time you thrive in life is going to depend on how well you move

pretty good stuff. I'm debating on sleep but I feel pretty beaten and wore out. It's hard to keep everything straight. I believe this is what's left ....

Mon - Phys Dx Exam 4

Tue - Diversified Practical & Cardiorespiratory Exam 3

Wed - Rad Positioning Practical & two h/w assignments for Basic

Thur -

Fri - Lab Dx & Basic III Final

Mon - Dx Imag & Toxicology Final

Tue - Rad P0s & Phys Dx Final

Wed - Diversified and Cardio Dx Final

Thur - Biomechanics Final

13 more exams & a couple homework assignments - I hope that's it.

A week after this tri is over, Irene Gold Board Review will be Aug 26, 27, 30 & 31.

I need at least an hour or two of sleep. Phys Dx and Diversified will be my close classes. I kind of feel like I'm the St. Louis Cardinals baseball team and each trimester is like our AAA minor league team. If the Cardinals were to play the minor league team 10 times then the odds would be in their favor to win. I should win each trimester (i.e. move on to the next trimester) but, ....triple A teams can be pretty good and the cards could have an off day - they should win 10 out of 10 but ....that's not a 100% guarantee.

We'll be finding out soon enough ...

time for a quick nap.

TRI-5, Wk13, Day 323 & 324 - Tue & Wed

I wish I had more time for these blogs but, school is taking up maximum head space right now. I think we only have 14 more test to finish out this semester. Lot's of stuff to study ...11 class days left - finals start next Friday with Lab Dx and Basic III.

Phys Dx is going to take a lot of work as will Lab Dx but, I'm not as sure what to study in Lab Dx.

Diversified needs to go well and that's what I practiced tonight with my parents.

I talked with Dr. Sanders the other day about the mechanisms behind chiropractic and, as of yet, the exact mechanisms haven't been proven and Dr. Sanders pointed out that we didn't know how aspirin worked for over 20 years after it's discovery but that didn't stop people from using it because it showed benefits in the area of pain relief.

Speaking of pain, I think of Dr. Christy who again pointed out that one the pain neurons get firing that there seems to be a cascade effect which makes it easier for subsequent firing of the pain fibers ...I went over this in some detail in a previous blog BUT not all neurons work that way. In the case of dopamine receptors, as are found in the brain, when there is a an abundance of dopamine then those receptors decrease in number. So, if something hurts and keeps on hurting then it will be easier to continue hurting but, if something feels good then it will take more to keep feeling good. The 2nd part of that statement is kind of a basis for addiction.

But, I was wondering - what if the dopamine receptors did become sensitized and lesser amounts of dopamine could accomplish the same job or if levels were kept high and additional receptors were made in the cells the it would be easier and easier to get those good feelings drom dopamine and, I guess the same thing could be said for substances like serotonin.

Then I was thinking about general life stuff ...I didn't think it through completely but I knew I'd thought about it before ...kind of a philosophical take on things.

Think of it like this ...which would feel worse, (a) never having a million dollars in the bank OR (b) having a million dollars in the bank and then losing it?

IF pleasure type receptors were to increase then that would be like having the million dollars in the bank BUT, since those type receptors decrease when there is an abundance of feel good type chemicals then we're kept closer to homeostasis, ...closer to never having the million dollars in the first place which would actually make quitting a habit such as smoking (which does provide extra dopamine production) easier to quit.

The craziness comes from quitting something like smoking is that our extra dopamine is cut back when smoking is stopped BUT our receptors for dopamine are still diminished because the body got used to all the extra dopamine. So then, we have fewer receptors with less dopamine and that doesn't feel too good.

Gotta get to bed and get ready for day #325. :)

TRI-5, Wk13, Day 322, Mon - Icepicks

So, we're studying drugs that act on the Central Nervous System (CNS) and considering ailments such as schizophrenia when we're treated to a film on how they used to deal with those types of conditions in the past.

It's quite simple really. You just shock your patient with enough electricity to render them unconscious then run to your kitchen to grab an ice-pick and find your favorite hammer ... lift up one of their eye-lids and press the ice pick in the upper portion of they eyeball until you hit the bony socket that the eyeball rest in ...pull out your trusty hammer and tap, tap, tap until the ice-pick has successfully penetrated the patients skull and has entered the brain. Now, with the ice-pick firmly implanted into your patients brain, make little swirling circles with your ice-pick to churn the front of the brain just right. Once you're done, simply repeat with the other eye.

Other than a bit of discomfort the patient is merely left with a couple black eyes that will heal up in no time!

Here's a link of the Top 10 Fascinating and Notable Lobotomies.

We also learned the correct way to stick our finger in a persons butt but ...I'll save that for another post (gotta have something to look forward to!) ;)

TRI-5, Wk12, Day 321 - Friday

It's 3:10 a.m. as I catch up on last Friday's blog. I'm studying anemia's for Monday's Lab Dx exam. I did get some reading done earlier in the weekend but also procrastinated and maybe avoided studying when I had the time but, I guess my brain is at a place where a break is needed every so often. I imagine as I improve I'll get better at doing things that are important but not quite so urgent.

I've been thinking about committing to knowing at least 1,000 things, maybe more, about all that I've been learning in school. So much comes at us and so much seems to slip by. I don't want to graduate and be stupid. Maybe I could look over some of my classes and pick out some of the more important things for each one and commit those things to memory. It shouldn't be too hard for a lot of things. I know there are 26 bones in the foot and I can name every one. I can pretty much name every bone in the human body ...

26 in each foot - 52 total

two tibias, fibulas, femers, say, four for the pelvis - that's 10 more for 62

24 vertebrae - 86

scapulas, two clavicals - 90

two humerus, two ulna, two radius - 96

8 carpal bones, 5 metacarpals, 14 phalanges in each hand, that's 27 times 2 or 54 plus the 96 (where's my calculator?) - 150 total

can't forget the hyoid bone - 151

in the face, we've got the mandible and maxila, 153

i guess the skull can be broken up into temporal (2), parietal (2), frontal (1) and occipital (1) which brings us up to 159

I think 206 is the average number of bones so maybe that total includes sesimoid bones and I'm not sure if the zygomatic arch is a seperate bone or not.

oh yeah - incus, stapes & da hammers ;)

another 6 for 165 total, that's 80%

(I'm now checking Wikipedia) :)

ok, there's 2 maxilla bones so, add one - 166

and yep, zygomatic is a separate bone and there's two of them so 168

I figured the facial bones is where I was lacking

2 palatine bones, 2 nasal, 2 lacrimal, vomer and 2 inferior nasal conchae - 177

i don't even remember that inferior nasal conchae to be honest with you ...

Dang! sternum - I should have had that one - 178

wow ...I forgot about the ribs ...ok, add another 24 - 202

Ah - cranial bones - sphenoid and ethmoid bone - 204

Well, that's pretty close - I'll leave it to the reader to find the two I missed (or where I added wrong)

besides the face, knowing those carpal bones in the wrist and the feet are kind of basic to know, especially as a chiropractor. I guess I should really know them all however.

Then there's stuff like Graves dz and Creatism which are hyper and hypo thyroidism, I tend to forget and get them confused with Cushings and Addison's dz (hyper & hypo cortisolism, respectively) I should at least know the basics of those diseases as easily as I know the colors red and blue.

For Lab Dx, I should know the normal values for common laboratory test.

I did peek ahead and learned we have 12 classes for Tri's 6 & 7. Also, our Minor Surgery Elective comes in Tri-8. There's also 16 different classes in Tri-8 .... hmmm

13 classes in Tri-9

Currently zero classes in Tri-10 but, I think that's mainly because of the clinic duties and I also think Logan is (or has) changed the curriculum to include a couple classes in Tri-10 by taking classes from an earlier trimester.

Better get back to anemias soon. I was wondering about the classes because I'm still not sure if I would mind becoming a mixed tri or not. A reduction in stress could be nice - guess I'll wait and see what happens. A mixed Tri just means a student spends two semesters to complete what's normally done in one semester but, since we're started from an accelerated program status, even breaking up a trimester is still a sizable load.

UPDATE!!! The patellas!!! knee caps - those are the last two bones - 206! :)