Monday, November 22, 2010

So despite Kristi and I having technique practicals and tests this week, we decided that we really needed to get away over the last weekend. We decided to go to Galena, IL, about an hour and a half up the mississippi. If you've never been to the Driftless Area of Northwest Illinois, Northeast Iowa, Southwest Wisconsin, and Southeast Minnesota, you really need to go. It is a beautiful area. It's called the driftless area because during the last ice age, when glaciers scraped and leveled all the northern area of the states, they somehow missed this area completely. So instead of the typical flatlands or rolling plains of the Midwest, there's a rugged topography with steep hills several hundred feet in height, rocky outcroppings of limestone, and deeply carved river valleys with a canyon effect. It's not anything you'de expect in the midwest. Galena is a historic town that was untouched by the modern developements of the post-war era, due to it's local depression of economy during that time. It's height of prosperity was the mid-1800's, and the architecture reflects that. Awesome Victorian, Romanensque, Greek Revival, Federal, and Vernacular architectural styles predominate the town, with 85% of the town listed on the National Historic Register. The Main St. area, where we stayed, has over 200 storefronts, all built in brick, 3 to 5 stories in height. The buildings create one continuous brick wall on each side of Main for about a mile. I've never been in a town quite like it. When I first visited there about 15 years ago, I fell in love with it, and I've been going back regularly ever since. This time we took our friends, Paul and Sharron. We've been friends with Paul for years, Kristi has known him for about twenty years. They're newlyweds, Paul married Sharron last January. Sharron is a perfect match for Paul. We don't get to hang out as much as we used to , as they used to live right across the street, but in the summer they moved further away, still in town, but before we'de see them about every day, and now we have to make plans to get together. With all of our busy schedules, it's been difficult to make plans. I'de say we see them about once a month now. This last weekend was great, as we really got to spend a lot of time with them, and we really got to know Sharron a lot better. It was a realxing weekend, mostly casually walking up and down Main, looking in the shops, and eating great food. We shared a two bedroom suite with a big living room , and we stayed up late watching movies on the flatscreen TV. We don't have cable, and neither do they, as life is usually too busy to watch TV anyway, so it was a treat for all of us! We're already talking about going back!



So back to reality this morning. Had a practical in thoracolumbar monday morning. I nearly did perfect, except I answered a question regarding one of my set-ups wrong. they ask you things like what's your DS, SCP, SP, CP, SSP, SP, STAB, PP, etc. They stand for things like patient placement, doctor stance, segmental contact point, segmental stabilization point, and so on. Well the teacher asked me SP and gave him the SSP on accident. Oh well, just one point missed out of 25, and a simple mistake. Not a big deal I guess.

Wednesday afternoon I had my first written exam in PT. It went OK, but I did struggle with keeping straight the different voltages and frequencies for different therapies. I'll need to review it more, obviously, before I start hooking electrodes up to people!

Thanksgiving today, as I'm finishing up this blog that I started monday morning... So happy Thanksgiving everone! Heading over to Kristi's cousin's house for dinner #1, then leaving from there to my Dad's house for dinner #2... I'm going to be stuffed by the end of the day! Well gotta go, have to load the van up.

Wednesday, November 17, 2010

This will be a first... blog entries two days in a row.

So this morning I didn't have to come in to Palmer til 10:15. Wednesday and Friday I don't have my morning class, Rad III. It's nice to have a slow morning. Not that I could possibly sleep in with such a busy house in the morning. Delaney is usually the first one up in the morning. She's so cute about it when she wakes up on her own. She shyly peaks her head out her bedroom door and quitely says over and over again "I up" or "I wakey wake" waiting for approval to leave her room. Then when she finally hears us respond to her, it's as if she's gotten the green light to charge out of her room and run up to our bed with a big smile on her face. This is on a good morning, and it sets the mood for the day. This morning, however...

Well lets just say she's like her mother. If she's not gotten enough slee, everbody pays. If we have to wake her, it's usually because she stayed up to late, which last night was certainly the case. On mornings like this she's a bear. Everything's an argument. What clothes she's going to wear. Wether or not she wears a ponytail. She wants to do everything herself. "My pony!!!" she yeslls when you try to do her hair. She can't do it herself yet; she just rubs the pony tail holder back and forth over her head. Then she gets frustrated and wants help. Then she changes her mind when you're only half done. Repeat with brushing teeth, and putting on shoes. And getting her buckled into the carseat... Makes you feel like you've had a full day's work, and it's only 7am. It's a good thing she's so darn cute, but I think she knows it, and that's not good. There's nothing like having a toddler to make you question everything that comes out of your own mouth, every action you take. She's a sponge, and everything counts right now. What seems like a great idea one day comes back to bite you the next.

For example...

Because of her independence, getting her to do something can be a challenge. She might not want to eat at dinner time, or go to bed at bedtime, and so on. But we've also noticed that she doesn't ever want to miss anything. So for a while when she was saying "I don't want to" I'de respond, "That's OK, I'll do it" like at dinner I'de say "Well I'll eat it then." She'd then change her tune and say "I eat it" or at bedtime "I go to bed" Well it worked fine for a while, then instead of "I eat it" or I go to bed" in a pleasant demeanor, she'd start screaming "No! My food! or No! My bed!" in a defensive, selfish tone. So all that time I was using reverse psychology on her I was basically feeding her innate toddler selfishness, creating a monster! I'm constantly amazed and humbled at the responsibility of parenthood. I try to not be too hard on myself, and remind myself that I'm learning as I go, but at the same time these are her developmental years, and I want to make the most of them. I certainly don't want to blow it. There's no choice in this, no option to procrastinate. It's game time, all the time, and every day, every moment counts.

Kind of like attending Palmer...

In that I mean that you get what you put in. Some students can sort of coast through, putting in the bare moticum of effort, and pass everything. But I question how much they're really preparing themselves to be accountable for their patients health. We're preparing to take care of people here. To be their trusted doctors. We're going to be a lot of these people's only, or at least primary, healthcare provider. If we were dozing off or not even present in class the day that some random insideous disease or disorder was discussed, we might totally miss it. Don't we owe it to our patients to be the expert they assume us to be?

It's easy to get in the mindset of memorizing new material to do well on a test, to pass a test, to pass a class, to move on to the next one. Then you do a brain-dump of most the material you just went over to make room for the new stuff. I don't want to do this, and I get mad when I realize that it's happened. Fro example, Kristi is about a tri or two behind me, and is taking classes that I took last tri or the tri before. As she's studying she'll ask me for clarification on something. When I don't remember the answer, or worse yet, don't remember even the topic, it worries me. Last tri one of my teachers put it very sucinctly when she said, "When you get out in practice, every day, every patient, is a test. And it's not multiple choice. They don't sit on your table and say "Patient presents with throbbing pain over left side of face and over the top of the head, gets worse with rest. Do you suspect (A)cervicogenic headache (B)migraine or (C)stroke?" And meanwhile, I'm thinking, do I adjust, do I even examine, or do I call an ambulance? Once we're out of here, there's no A,B, or C. We'll be the experts, and we'll be responsible to do right for our patients. Period.

So basically I'm in no hurry to get through the classes. I'm trying to retain all that I can, and make the most sense of everything.

Speaking of which it's time to go to class, got P.T.

Tuesday, November 16, 2010

SO now we're a couple weeks into the tri, I can let you all know what I think of the classes I'm in now. I'm taking 4 DC classes and 3 BS classes this tri, with a total of 30 hours.



First thing in the morning, 3 days a week, MTH, for two hours I'm in Radiology III. This Rad class is all about the Physics of x-ray. How it works, radioactivity exposure, etc. I find it very interesting. A lot of people in the class don't care for it, probably because it's physics stuff, and it's first thing in the morning. I've always been fascinated with how things work though, so it's right up my alley. Dr. Rowell is nice and funny, and he makes the class very interactive. Later in the tri we get to start taking x-rays, just of models, but I'm looking forward to that.



After Rad I have an hour break, which I'm utilizing right now to blog...



Then my favorite class this tri, Thoracolumbar adjusting with Dr. Bovee. This class is awesome! Dr. Bovee is making this class so much fun. He's as much of an authority on Palmer Gonstead adjusting as you'll find. I think he's taken more post-grad adjusting seminars in Gonstead Methods than anyone in the world. He teaches the listings on a conceptual level, so we get to rationalize and think through the listings and set-ups, rather than memorize things like doctor stance, contact point, etc. You still need to memorize these things, of course, but the way he teaches the material, every listing we get, we think through the "why" and build the set-up. I learn a lot better this way. I'm not big on rote memorization. If I understand why I'm doing something, I'll for sure remember how to do it. Dr. Bovee is such a personality too. He looks like Bob Ross, right down to the poofy hair and goatee. He usually wears untucked Hawaian print shirts. He's very laid back. Always cracking jokes. Totally my style.



NMS II with Dr. Brozovich is about the neurologic and orthopedic tests of the lower extremity, building on the knowledge learned in NMS I last tri. Dr. Brozovich is full of stories about practice life, and being an expert witness in court. Lot of legal stuff in this class so far, like what you could get sued for if you fail to perform. It's insightful to see this aspect of the realities of being in practice.



Then another hour break...



Then on MWF I have PT II, again with Dr. Rowell. This is the passive therapies portion of physiotherapy, last tri was active therapies ( exercises and stretches). Passive therapy is things like hot and cold, electrotherapy, ultrasound, cold laser, stim... There's a lab with this class, and last week we had to experience the four stages of an ice water bath. I had to stick my hand in a bucket of ice with just enough water to fill it up, but it's all ice! 15 minutes through cold, burning, aching, then numbness! Ahhhhhhhh!!!!! Those polar bear club members are insane. That's all I'm saying. Certifiable.

Signing out for now, time to go to class...

So I had lab in PT again today. Today we hooked up electrical stim on each other, learnng the different voltages and frequencies to use for different reasons and body areas. Dangerous. Fun.

Kinesiology, a bachelor's class, Monday nights with Dr. Pavlicek. He heads the rehab department and has a background and keen interest in sports. This should be a great class, and I guess about 70 other students thought so too. The typical B.S. class has about 15 to 20 students. I've never seen more than that, so 70 was a shock. Dr. Pavlicek is a great guy. He's about 12 feet tall and 500 pounds. OK I exagerate. But he's a big boy. First name Ranier. Like the Mountain.

Wellness, a psychology B.S. class with Tara Kelley is on Tuesday nights. Our class project involves picking an aspect of our own life that needs improvement for the sake of wellness. I decided that spending more meaningful time with friends was something lacking in my life right now. Ever since starting Palmer, getting married and having a kid, while renovating the house, I've had no time to just hang out. Go figure. Well not anymore. Last Friday I had a good friend from Palmer come over for dinner. It was nice to hang out with him outside of school for a change. This weekend Kristi and I are going to Galena, IL with friends. We reserved a two bedroom suite in a little inn right on Main St., so we can be next to all the stuff to see, do, and eat. I'm really looking forward to this, as our entire break I spent working on the house, and I still am every free moment I get. I really need a break! Galena is my favorite place to get away to. I've been going there fairly regularly for about15 years now. It's been a couple years now since we've spent the night there. We've visited quite a bit more often, passing through, but it's high time we spent a weekend there again!

Oh yah classes.

Finally there's Small Business Management with Karrie Holland. I took a marketing class from her last tri and really enjoyed it. She has an MBA and owns 3 or 4 locations of Cartridge World here in the QC. It's nice to have a business teacher that's in business, and can bring current and practical info to the class. Really looking forward to this class with her.

Once again a full plate and they call it "reduced schedule."

Winter tri is a long one for a couple reasons. For one it's the winter. Iowa winters are brutal, don't let anyone sugar-coat it. Daylight seems to last just a few hours. It's dark by 5. It's dark til 7. So on days I'm at school from 7:30 til 6:15, I'm in class from dark out to dark out. Not that I'd want to be outside when it's 10 degrees out. the other reason the winter tri is so long is that it's broken in two by a 2 week holiday break. Keep in mind that the fall break is two weeks long and the spring break is one week long. So when you get back from the holiday recess it feels like you should be starting a new tri, but really you're right in the middle of one. Usually you come back to tests waiting for you.

Sounds like I'm complaining, sorry. Don't take me wrong. Here in the midwest we like having cold dark winters, and we like to complain about them. It's like going to the gym. Feel the burn. It's good for you. No pain no gain. Makes you appreciate the other 3 seasons all the more. It's probably good for us in some Innate way, being a serious challenge to our survival instincts. Sympathetics kick in, endorphins circulate, pain decreases...ok it's too late to start talking neurophysiology.

Speaking of too late, it's now 10:10 and 10 minutes past my bedtime. Laney's been fighting going to sleep for the last 2 hours and I'm wiped out.

Tuesday, November 9, 2010

Been a while...

Well, what can I say, it's been a while. A little after my last post, we decided that we wanted to tackle some exterior projects on the house before winter sets in. Nothing major, just rip off the two layers of siding, old drafty windows and front door, then blow in insulation, wrap the house in more insulation, install new wood windows and cedar siding. We're going Craftsman on our house, with period details and materials. Also means a LOT of work. All the siding had to be primed front and back, and we pre-painted it before I hang it. Not quite done with the siding, hopefully this week... Was hoping to get it done over our 13 day break between tris. I literally put in 12 to 15 hour days every day of the break. Kristi and Dartagnan helped a lot, and my neighbor across the street and a friend have lent a hand when they could.



Our neighborhood is an awesome little enclave right by the river in downtown Bettendorf. The houses were all built between the turn of the century and 1950 for the most part. The lots are mostly 50 feet wide and the houses sit just 25 feet off the sidewalk. Its a walking, biking, running neighborhood. There's a great city park just a block from our house, and a little grade school and another park just 3 blocks in the other direction. We know all our neighbors, most of them well. It's the closest thing to a perfect little neighborhood you're likely to find. So anyway, every day I'm out there in the front yard, cutting and hanging siding, and attracting a lot of attention from the neighborhood. The friendly outside sales rep for K&K True Value, Dave, stops by about every day to check my progress. He gives me pointers and makes me feel like a pro at the same time. The mailman, also Dave, always stops and chats for a couple minutes. He even disclosed the home address of the hooligan who threw a rock through one of the old windows stacked up behind our garage in the alley. When he rolled by later on his little scooter I told him I knew where he lived, and by everything holy his mother would cry when she saw what I did to him... OK I didn't say that last part. But we did threaten police intervention. Probably scared the begeesus out of him. hehehe. Haven't seen him roll by on his little scooter since. We really love our neighborhood, and I'm sure we'll miss it sorely when e move after graduation. We talk about keeping the house, but honestly I don't think we'll be able to afford two household right out of school. It will be very hard to walk away from this house after all the hard work and love we've put into it.



Maybe that's why there's so many chiropractors in the Quad Cities. They all came to here to go to school, then met their spouse here, got involved with the community, or a church, whatever, and well, just never left. I don't think they all lived here already. Whatever the reason there are a ton of chiropractors here, and our business coach assures us that it would be a huge challenge opening a practice here. I tend to agree. Anyway I don't think either of us really want to stay here. We're always looking for the perfect place to move to after we're done here. It's always changing. When it's cold outside we start thinking South. When it's hot we think North... we talk about practicing with our friend in Australia, or going to New Zealand. We still have some time to figure it out I guess, but we both like having a plan, so it can be as stressful as it is exciting to think of all the possibilities...

So it's a new tri, seems like maybe that's how I started my last post... At the beginning of the tri it's easy to think you have all the time in the world. No tests looming, no grade yet. Starting fresh. But the tri hits you quick. Around thanksgiving, right before and right after, I have several tests. So there's not a whole lot of time to goof off, There's reading assignments to keep up with. For example in NMS II we have weekly quizzes, and this week's quiz is over 180 pages in the most dry neurological exam book you'll ever see. I've yet to pick it up without falling asleep. And it's fascinating stuff! We'll be performing these tests, analyzing the function of these nerves for the rest of our lives. But this darn book could make the most interesting subject boring. It's in it's millionth edition, and is THE text for the neurological exam, so there's no way Palmer wouldn't use it for reference. I just wish they'd mix it up a bit, maybe use, I don't know, pictures, perhaps. Seriously the thing looks like The Bible. OK so there are photos in it, all black and white though. They should use color. And people from this century. There's other books I just love though. Evans Orthopedic Exam is a great one. Mosby's Physical Exam. As an artist I love the Netter Atlas for Human Anatomy. Rather than photos of dissected cadavers there's wonderful painted illustrations of dissections. Nerves are yellow. Arteries are red, veins are blue, and lymphatics are green. Muscle bodies are bright red, and the tendons are bright white. Everything's neat. With photos of cadaver, it's like a pile of muck, all the same dingy gray tan color.
Studying with cadavers in person, on the other hand, is fascinating, and nothing, not the greatest text, could ever replace it. We're fortunate at Palmer to have an awesome cadaver lab. There are five classes in the curriculum that utilize cadaver studies: CNS, Gross Anatomy One and Two, and Spinal Anatomy One and Two. All of these classes are in the first year at Palmer. But as long as we're students we can use the open lab hours in the cadaver lab, and have access to most of the specimens to study on our own. It's truly a privilege to be able to study the human body in this way, and I marvel at the thoughtfulness of the individuals who donate their remains for the advancement of knowledge. Kristi and I want to do this... just not any time soon.

Well it's time for bed. I think if I post at night after I can't work on the house or tend to our children, maybe I'll get to it a little more often. Oh wait, that's when I study...

Until next time.