Have I mentioned yet how hectic 7th tri is? Wow. It's like I'm trying to juggle a full-time job (clinic) and a full-time class schedule. Yesterday I had to be two places at the same time. I had to deliver a radiology review on some x-rays I took Tuesday night. When you take films, it's an iron-clad rule that you write a report and present your findings either the same or the next day. This is very important as there is a patient waiting to find out what the x-ray results are. Patient care always comes first. Well, I took the films right before close so that meant I needed to report the next day. there's two times you can present, morning (9:30) or afternoon (3:00). I didn't dare sign up for the morning, as I wouldn't even have access to the films to review them and write my report until 8am. It was my first rad review, and I wanted time to do properly prepare. So I signed up for the 3pm time, which is when I'm supposed to be in Clinical Methods. So I missed Clinic, and you can only miss twice, 3X and you have to repeat the course the next tri, which means graduate a tri later. Hopefully nothing comes up again this tri!

Well turns out I wrote my report wrong, based on the type of films I took. So I was told to redo my report and present the next day. I did that today, and it went much better! He could have made me do what's called a case study, where you do a big research paper and presentation on a specific radiology finding. You have to complete 10 of these anyway, but I didn't feel like that being lumped on my plate with everything else going on, and Part II and PT boards fast approching next month...

Oh! Gotta get to Tech Review class! Practical exam tomorrow!

Well a few weeks into the clinic experience and I'm happy to report that I have two new patients, and have been able to perform physicals, report of findings and deliver adjustments, and perform physical therapy. It's so exciting to be putting into action the things I've been learning these past years! Life is rather hectic right now, juggling clinic with my class load and home life. But it's all fitting together rather nicely.

It's been unusually hot this summer here, which has me second guessing moving south to practice after graduation! I think I was getting used to the mild summers (compared to Florida). It's been over 100 nearly every day for the last three weeks it seems! Lately I've been researching British Columbia, Canada, as a possible location for us. We have friends practicing up there, and the winters are actually milder than ours where they live! Summers don't get anywhere near as hot either. That's looking really enticing, I have to say! Last week the central air went out in my house. We were miserable for four days, waiting for attempted repairs, and finally a complete replacement. Ouch. Cost a fortune. (Well, a fortune for a student anyway, $2600!!!) Sure feels nice to have air again though!

The temp actually finally dropped today, it's only in the 80s. Feels cool by comparison! Homecoming at Palmer this weekend, so it's a short week. No classes thurs or friday. We were planning on attending, especially since a friend of ours will be presenting a seminar. We decided that since we didn't get a family vacation this summer, we really needed to get away for a few days. We decided to go up to Washington Island, on the tip of Door county Wisconsin, in lake Michigan, to visit my Mom and Step-Dad. It's been unusually hot up there too, but the forecast is looking nice. It's a 7 hour drive, plus a 45 minute ferry ride to the island, but it will be worth it to unwind for a few days and enjoy my Mom's awesome cooking! Laney and dartagnan love swimming in the lake too, so everyone should enjoy the time up there.

Well, gotta run, I have an appointment coming into the clinic. Yea!!!

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!