7th tri is busy!!!

I've heard it over and over as friends in higher tris enter 7th.. Life gets very busy!

Well, I'm here to report, it's true!

Now if you've followed my blog at all you know that I'm on a "reduced schedule" to keep balance in my life between family time and school time. A wife and two kids, and a home in the middle of major renovations, means I have to reduce my course schedule to compensate. This tri is no different, my fellow 7th tri students are taking several courses that I took last tri. My schedule is pretty light in comparison. I am taking two electives and two bachelor's classes as well, but still, less hours overall. Well I'm run ragged! Came down with a cold over the weekend. Summer colds are the worst! I know it's because I'm stressed, not getting enough sleep, and pushing myself too many hours in a day... What can I change though?

My friends also assure me that it gets a lot easier in 8th, to keep that light at the end of the tunnel in sight and it will all be fine. So far so good. I'm very excited about the transition into clinic. I love being in the clinic, being exposed to the hectic atmosphere of a high patient volume. It's what I want for my own clinic one day. I thrive on a busy schedule; the busier I am the more I get done, the more efficient I am. I feel better when I'm busier. I just need to transition back into it. When I was a salesman for a living, I always preferred the busy days to the quiet ones. Time flies when you're seeing customer after customer, and you get into a rhythm. Well patient encounters are no different in that respect. Last night I was having the time of my life going from patient room to patient room, from encounter to encounter, each a unique situation. Each patient is a puzzle. How could anyone view this as work? It's fun, it's stimulating, it's rewarding. Can you tell I'm excited?

The stress is from being nervous about doing a good job. I don't want to hurt anyone, or miss something important on an exam. It's sure to happen I know, but I can't help worrying about it. Also, juggling the heavy class load with clinical responsibilities is stressful for 7th tri. 8th and beyond there is very little classroom time; most of your hours here are spent in the clinic. 7th has a lot less required clinic hours, but it's all new, so a lot of time is spent just making sure you're in the right place, talking to the right person, filling out paperwork the right way, etc. It becomes a whole lot to keep track of really quick. I have two different planners now, my class planner and my clinic planner. There's no way everything would fit into one!

None of this should scare you away from Palmer. By the time you hit 7th tri, you are well prepared for clinic. Everyone stresses about it, but everyone gets through it. I look at classmates from higher tris or those that have graduated already, and remember how we stressed about the same classes in the past. They made it through those same tough classes in 1st through 4th tri's, and made it through everything I'm struggling with now. That gives me confidence that I can too.

Finally in the clinic!

Well 7th tri has finally arrived for me, which means I will soon be "cleared for clinic"! This means that I have reached a point where I can start treating patients in the campus health center, one of our two clinics here at Palmer. The Campus Health Center, or CHC in Palmer lingo, is the student clinic. The patients, for the most part, are fellow students. You can also bring in family members, and treat faculty and staff there. The other clinic, the Academic Health Center, or AHC, is open to the public. It's our mac-daddy, state of the art, HUGE clinic building. I think it's the largest chiropractic clinic in the world, but don't quote me on that. It's certainly impressive. The highest quality digital x-ray, treatment equipment, physical therapy dept., etc. It's awesome! I'll be over there next tri; looking forward to it! I'm equally excited about being in the CHC though. I really like my staff doctor, Dr. Krayanhagen. In our clinic system all the student doctors are assigned to a staff doctor, who oversees all patient management. We're learning, after all, and an experienced doctor looking over your shoulder, giving advice and input, is crucial, both for patient care and student learning.

This week and next we are in "observations", where we are observing an 8th tri student treating a patients, following our staff doctor, learning clinic protocols, etc. Next Friday is our Clinic Induction Ceremony, and the following Monday we are cleared. Yeah!

I'll post regularly through this transition, so stay tuned...

My first official clinic observation

Tuesday night I had my first clinic encounter observation, as part of my Intro to Clinic class. Exciting! I've observed dozens, if not hundreds, of clinical encounters, through shadowing my chiropractor, and other mentors since. Also, I've observed plenty with my wife and kids. But there was something different about this one. I think being in a clinic jacket, in a professional role, changes the perspective immensely. With observations, you are a silent party, but you are definitely taking notes as questions are being asked, findings delivered, treatment administered, and so on. This is an excellent opportunity to quitely assess what you would do with that same encounter, and to learn from the intern and staff doctor.

I can't discuss the particulars of the encounter, as that would breach HIPPA rights. While I could discuss details without divulging identifying information, I'm not even going to do that, as the details could identify the patient. I wouldn't dream of breaching that trust. It really is a profound privledge to be trusted with sensitive personal and health information, when you think about it. There are things discussed in a doctor's office that that person might not be willing to share with anyone else, including loved ones. This is just another aspect of how much responsibility is placed on a doctor.

In a few more months it will be me that is making those calls, and being observed by a fellow student. Time flies here.

Lots of tests and practicals this week!

I just finished two back to back. Had a mideterm test in visceral disorders. It was mainly on CBC (complete blood count blood indices test) with all the anemias and leukemias. But there was urine on the test too. Well, not literally... The first test was over UA (urinalysis) and everything it can uncover, and there were several review questions of that material on this test, especially because several diseases can cause abnormal findins on a CBC and a UA, so cross-correalation is important. Radiographic findings also relate to alot of things we look for when we order lab work too, so that is on the visceral disorders tests too. I'm definitely at a point in the curriculum where it's critical to put together all the seemingly disjointed material covered in dozens of other classes. DOn't think for a second that once you get through an anatomy or physiology course, and pass the class, that you're done with that material. Besides having to know it for Boards, you really need to know it to be a competent doctor!

After that test I had to take a Pelvic class practical. This one focused on being presented with a mock patient, with films and physical findings. and then having to determine listings, best adjustment, pre and post checks, care plan, and patient instructions. I missed one silly point because I accidnetally said ASIS when I meant to say PSIS. (These are bony landmarks of the pelvis, one is on the front of your body and the other on your low back. Obviously I didn't have them confused, just my Dislexia kicking in at a very inoportune time!Oh well just one point.

I've got an exam in Intro to Clinic wednesday, and a clinical psychology test thursday. Friday I'm delivering a 20 minute presentation on the social implications of Hepatitis B in my Social Aspects of Epidemics undergrad class. I also have a group investing project that I'm involved with in my Economics undergrad class.

Like I said, busy week!

Not to mention I'm putting up 200 feet of privacy fence, stick-built (not pre-fab panels, but piece by piece), scraping, priming and painting the garage, tilling and reseeding the yard, while I have several indoors renovation projects going on too, like hardwood flooring and tile throughout the entire house, etc...

Life is never dull!

Well, gotta go to extremities class to play with stinky feet.

Palmer Package Club

This morning I went to Palmer Package Club. Clubs meet once or twice a week on campus, and there are plenty to choose from. Every specific technique has its own club, then there are clubs that revolve around other interests, like sports, pediatrics, etc. Palmer Package Club focuses on Palmer Package, which is the group of techniques that are part of the standard curriculum here at Palmer. The main components are based on Toggle, Gonstead, Diversified, and Thompson. They are tweaked here and there to reflect current research, best practices, etc. Palmer has done an excellent job at integrating several techniques into an extremely cohesive "toolbox" of adjusting protocols and techniques. We get tons of hands on with all of these techniques within the specific courses, of coarse. THe club is an extra opportunity to go through the entire history taking, exam, findings, and actual adjustment, with another student, and a doctor observing. It's the real deal, not a mock experience. This to me really is the best tool in learning to put it all together, and practice a real chiropractic adjustment, rather than just setting up, then practicing the thrust into the air, which is of course all we can do without having a real patient with a real need for an adjustment, something that can't be controlled or guaranteed in a classroom setting.

So this morning I went through the whole process of finding two subluxations, reviewing films, history, everything, then pick what I thought would be the best adjustment technique for those subluxations, and correct them. It went great! I had to switch techniques on one of them because it didn't respond to the manuever I had first chosen, but then I was able to pick a different procedure that would work better, and it did! It's a great experience to be able to be put into that clinical mindset, where I have to think on my feet, reassess, and move forward. Next tri I'm in the clinic, so I've got to start thinking this way!

This tri is awesome! As I've said before, I'm halfway between 6th and 7th tris due to my individualized schedule. I'm taking two technique courses, Pelvic Adjusting and Extremities Adjusting. It took me about a week to get used to Dr. Petterssen's demeanor; he has a very dry sense of humor, which I greatly appreciate. He's a great instructor. He wrote the book on Pelvic adjusting. Really. Dr. Sorgenfry teaches my Extremities class. This doc reminds me of my doc back home. Country at heart, he runs the family farm as well as teaches here. I can really relate to him, being raised in the country myself. Yesterday he gave away free eggs from his chickens to whoever students wanted them. Dr. Sorgenfry is very approachable, warm, and obviously caring. A great example of his dedication to teach is that he is starting up a student/doctor mentoring program with Palmer alumni out in the field, where we can get paired up with doctors practicing in the area in which we want to practice. We will get to go and shadow them in there practice a few times a year. I'm especially looking forward to this as I plan on practicing on the west coast of Florida! Great to have yet another excuse to get down to Florida a few times a year! Since we are planning to locate the practice somewhere on the west coast between Tampa and Naples, but are unsure of which town exactly, it would be very helpful to travel to that area and get a good feel for the different communities, while also getting priceless input from a Chiropractor working in the same area. I truly appreciate Dr. Sorgenfry putting this together. The idea to do this evidently came from an offer from a doctor that was here for the last homecoming, wanting to mentor a student in his practice. It's exciting to see that doctors busy with their own practice and life would want to take time to give counsel and advice to emerging doctors. Its exactly this type of gesture that will help to grow this profession to still higher levels of service and dedication. I'm in the Intro to Clinic class this tri. Name says it all. There's a lot to cover in preparation to start treating patients. Lately we've been discussing issues like Code of Conduct, Ethics, HIPAA, professionalism, Report of Findings, and so on. We had an assignment to actually deliver a report of findings on video recording, so that we can see ways to improve this critical visit. This was an excellent lesson in the power of how we interact with our patients. Subtleties like body language, rate of speach, filler words, eye contact, confidence, and so on, all add up in a huge way. Later this tri as part of this class we actually get into the clinic and do silent observations of doctor patient encounters. I'm really excited about this. First step into the clinic!! In visceral disorders calss with Dr. Tatum, we're learning how to know what appropriate labs need to be ordered in helping to diagnose all the various visceral disorders, and how to interpret these labs. For example, based on information in a patient history you suspect that the patient could be diabetic. We need to know that the proper course of action is to order the appropriate labwork to find out if your suspitions are correct. You need to interpret those labs, and follow up with the appropriate course of action. As Chiropractors we are often a patient's only regular healthcare vsit, and we are on the front line with the patients, and need to be able to recognize any helath problem they could present with, and offer the correct advice. This is huge. It's taking classes like this one that really shout to me "You're going to be a Doctor!!" It's a profound feeling, knowing the responsibility I will soon have to people's health. Scary too, but in a good way. Scaring me into doing everything I can to be the best Doctor I can be, deserving the trust that will be placed in me. Well time to go to Vis Dis. (Visceral Disorders) Talk to you soon.

Just talked to my brother. He's a Palmer grad, class of October, 2009. It was Josh that talked me into coming to Palmer, over the course of two years. When he started I was still living in Florida. I was so proud to see him get through Palmer in 10 tri's, while having two kids. OK it was his wife that had the two kids, but I think he's changed a few diapers. She made it through in the same 10 tri's. They're super-human. Meanwhile, I started in July 0f '07 and won't finish until October of '12. Took two tri's off to make some money after my daughter was born. Lucky if I broke even; honestly, I'm sure I lost money. The bigger part of it was probably that I couldn't wrap my head around becoming a dad for the first time and still focus on school. The tri that she was born I failed almost all my classes. We're all wired differently I guess, and Josh, I would venture to say, is wired better than I am. I'm better looking, though. Well, not really, but I like to say it. Mom loves me more though, she told me herself. She made me promise not to tell Josh or my sister Jani.



Anyway, I'm immensely proud of my little brother. He's a great dad, great husband, great doctor, and he was even the drummer for a metal band for a while. Cool.



So anyway just talked to him. He wanted my advice on a couple of different used cars he's considering buying. I used to sell cars, and lots of them. Yeah, I'm the used car guy everybody dreads. "Come over this way, I just got in a real peach, and I'm sure it won't last a day at the price I've got on it. Got it for a steal and I'll pass the savings on to you. How's your credit?" Ah, the memories. Advice from a reformed car salesman. Never trust a car salesman.



It was nice to catch up with Josh. We don't talk enough. Asked him about how things were going in practice. They're going. He's working, along with his wife, in her dad's practice. They're self-employed, renting space from him. Business is growing, slow but sure. He's busy working on a diplomate in whiplash care, and also working on a certification in accident reconstruction. He's going the route that I'm interested in going, which is PI (personal injury) It's a lucrative and rewarding aspect of practice, if you can stomach working with attorneys all the time. His father-in-law does quite a bit of PI business, and is an expert witness in demand in the Peoria area. I would love to one day focus on helping people recover from an accident, having been in a couple myself. To not only help them on their road to physical recovery, but also help to make sure they are fairly treated by the insurance companies, now that's what I'm talking about. I used to work in the insurance business too. Worse than used cars.



I told him I'd like to shadow him in practice some day coming up. He politely told me I'd be better off with Doc (dad) as he's not seeing anywhere near as many patients as Doc is. I shadowed Doc for a while before deciding to come to Palmer. I was considering Physical Therapy as well. Doc said "Now why would you go to school all those years to not be a doctor?" Made sense to me. Shadowed some PT's for a while too, though, just to be sure. I learned that pretty much all PT's either work for a hospital or a large PT center; hardly any strike it out on their own. I asked them why and they said that the equipment costs a fortune, so it was only cost effective to be in large groups. Also, they're not portal of entry for patients, meaning pretty much all their patients are referred from other docs, who write a presciption for therapy. Since most hospitals have their own PT department, and most doctors are associated with a hospital, it would be difficult to make it if you started your own company. Well, I have no interest in working for a hospital, or for anyone for that matter. Also, I knew I wanted to be a primary care doctor. I want to diagnose. I want to be a doctor, not a technician. Now don't get me wrong, I have huge respect for PT's. They helped me immensely in recovering from my car accident, literally re-teaching me how to walk. Awesome work, what they do. It's just not the route I want to go. I'd rather be the guy writing the presciption for PT, determing the need for PT, than be the guy performing it. That's just me.



I'm really looking forward to being done with school. I love Palmer, love the classes, love the teachers. I feel it's the best school in the world to learn Chiropractic. But I can't wait to get out into the "real world" again. Josh tells me to enjoy Palmer, that he misses it. He says the stress of passing classes and board exams has nothing on the stress of going into business. I believe him, but I still can't wait. 5 more tri's including this one. I start seeing patients next tri. That's exciting! I've watched the class I started with graduate, last October, and the one I spent the most time with just a few weeks ago. And I'll watch four more tri's of students I've shared classes with along the way graduate too. Lot's of friends come through and pass me by, on my "slow track". I don't feel bad about it; I know it's what's best for my family. But sometimes it's hard to feel left behind. Oh well. I re-study all the classes I've taken. This tri I plan on sitting in on a few classes I've been through, just to get a firmer grasp of the material. I'm not taking a light load just to have a light load, I'm doing it to be a better dad, better husband, and someday, better doctor. My brother could do it in 10, and do it all well. But he's super-man. Funny, when we were little, he thought I was superman, being 5 years older than him. Lately, I have to remind myself that he's the younger one...Because I look younger...well, not really...