Almost done with clinic

Now that Boards are over most of my time is spent getting ready for precepting and moving across the country! We have two weeks left of classes for my trimester, and I still need to get two more physical exams to finish my graduation requirements. I have a bunch of paperwork to get turned in after I finish up those physicals.

I started packing up and cleaning out my apartment last night. I threw away a lot of things, gathered a lot of things for a garage sale and textbooks to donate, and started packing up the things that will come with me! My apartment looks too bare right now, but I have less than a month before moving day!

I am very excited to start this new journey. I’ve talked to the doctor I am precepting with, and we’ve set up a start date. We are both very excited to start working with each other. I am very excited to see the difference between how her office is run and how we run the clinic. I can’t wait to learn all aspects of how to run and operate an office, and I’m excited to start adjusting again! Having to take a month off from adjusting is going to be dreadful. I love adjusting, and when it’s been a long weekend or a break, I find myself missing it. I love that I’ve found a profession where I miss doing what I do when I’m unable to work for short periods of time.

I know I will be busy enough to keep my mind off it, though. Moving across the country is not an easy task. I’m glad I only had to do it once. I came to the Quad Cities from Burlington, Iowa, so it was a short trip to move here. Moving 18 hours away is a whole different story, but I couldn’t be more excited. I can’t wait to be a short drive from the beach and never having to freeze again. I will not miss Iowa winters, that’s for sure. I will miss several things about Iowa, but maybe that will be my first entry once 10th tri starts!

-Allisha

My Clinic Abroad experience

Adjusting in the clinic

Adjusting in the clinic

I was able to talk briefly about our journey to Clinic Abroad. Well now I have time to actually talk about my Clinic Abroad experience. I had the privilege to go to Bequia, a small island in the Caribbean off of St. Vincent in the Grenadines. We were there for about 10 days providing care to the people of Bequia. I can honestly say I have never had an experience quite like this one. Everything was absolutely amazing.

We arrived on a Thursday around 5 p.m. We got to our hotel and had dinner then went down to the ocean front and got to see a steal drums performance. Every night a different restaurant had live music and dancing. Thursday night was the steel drums.

The kids!

The kids!

Friday morning was our first day of clinic. We started almost every morning going to the different schools on the island and seeing the kids. I can’t even accurately explain how excited the kids were to see us. We would have children from other schools cheering as we walked by, hoping we were coming to their school that day. At lunch we would get stopped by kids asked when we were coming to their schools.

We did a fundraiser before our trip and sold little stuffed bears to give to the preschoolers. They loved them and the stickers we gave them. It was really cool to see such young people get so excited about something we take for granted sometimes.

Playing with the kids at school

Playing with the kids at school

That afternoon we opened up our clinic on the veranda at our hotel. Our view was overlooking the ocean. We couldn’t have asked for a better set up. We ended up seeing so many people and you could tell these people were just so grateful we saw people do things they haven’t been able to do in years. We saw people get out of pain they’ve had for months. We had people come back and tell us that visiting us last year changed their lives and they haven’t been in pain since, but they just wanted to come see us and get checked just to be sure. Everyone was so happy to see us, and after we had been there a couple days, we would get stopped on the streets and thanked for being there or asked what our hours were because they wanted to come see us.

We got to be immersed in the culture. And the food was delicious. I tried things I would have never thought to have tried. I found a favorite vegetable I’ll never find again. I am terrified of sharks, so as a personal victory one day I ate shark! I tried conch, barracuda, various island fruits and had the most delicious burrito and burger I’ve ever eaten.

Hiking up the volcano

Hiking up the volcano

We spent every night at the ocean with the most beautiful views. We went on a sailboat cruise to the Tobega Keys and snorkeled at World’s End Reef, which was just absolutely amazing, even though I got slightly sea sick. The night before we left, six of us hiked the volcano on St. Vincent.

The travel back was a little rough. We had planes delayed and missed flights and more delays and sitting on runways for hours, but we made the best of it. After getting home 24 hours later than we were supposed to, we still had a great time with wonderful memories.

The beautiful beach

The beautiful beach

The first rule of Clinic Abroad is to be flexible. We learned that first-hand on the way back, but even with that, I have nothing to complain about.

I can’t express how grateful I am for this experience. I wouldn’t have changed anything. If you ever get an opportunity to do something like this, just do it. You will not be disappointed, and the people are so grateful. I can’t pick a favorite moment–I can’t pick out what I liked the most because it was all just so perfect. I went with a group of classmates and left with a group of friends. I watched my classmates transition from students to amazing doctors, and I am more than happy to call each and every one of them my colleagues and friends. We really changed lives while we were there, and I think our lives were changed as well.

An experience I will never forget

An experience I will never forget

We all learned to be a little more grateful, a little more appreciative and a little more humble.

-Allisha

Another tri done!

My new home on campus ... the Davenport Clinic in the Academic Health Center!

My new home on campus … the Davenport Clinic in the Academic Health Center!

The trimester has come and gone once again. These last couple of weeks have just been preparing for just that–the end of the trimester. We haven’t really been doing much except spending more time in clinic. The 9th and 10th trimester students are finishing up their adjusting credits, so my trimester is starting to take over more of their patients.

Other than seeing patients we’ve gotten through finals. This is the first trimester we haven’t had a full week of finals. Our last test was on Tuesday, then we flew out Wednesday for Clinic Abroad. I went to clinic in the morning, saw a few patients and had to be at the airport at 2 p.m. More on that to come!

Eighth trimester flew by. Everyone says it’s the most laid back trimester, and finally something I was told so long ago in first trimester has been right! I really enjoyed this trimester finally getting into the outpatient clinic seeing patients with more complex cases and not being in class all day! At first I was having a hard time dealing with all my free time. I wasn’t sure what to do with all of it, I got over that quite quickly with a lot of netflix and naps. I had 7 trimesters of naps to catch up on and 8th trimester was a great time for that.

That being said, I’ve had a great time in my first trimester in the outpatient clinic. I have seen a wide variety of patients all making improvements and some already fully recovered. I’ve used skills I didn’t think I would use much. Most surprisingly I went into clinic thinking I would be using mostly one technique, and I have actually used a wide variety of adjusting techniques. The one I thought I wanted to use the most, I probably used the least. It is all about finding what fits best for you and your patients, and that might not be the same thing for every case. I’m excited to see what 9th trimester brings.

Now, I’m off to Bequia!

Getting ready to precept!

Florida, here I come!

Florida, here I come!

Today I write to you from an airplane! I am on my way back from Florida! I spent the last two days in the sunshine and on the beach away from the cold and snow!

No, really I came purely on a business trip. I actually met with three different field doctors to talk to them about potential precepting opportunities (!!).

Palmer’s precepting program allows its students to go out and work in an office with an approved field doctor. There are doctors all over the United States that are eligible to host student interns, and this program allows us to learn from someone who has been out in the field for a long time. It also allows the field doctors to learn from us! The profession has grown so much that everyone can benefit. They also get the extra help around the office and get an opportunity to help out a student.

So most of Thursday I spent meeting with the doctors and talking to them about their practices and trying to decide which place would be best for me. All three offices were very different and had really different things to offer. It was a really hard decision to make, but I think I have decided on which office would be the best fit for me!

I am very excited for this opportunity and being able to have met so many wonderful doctors out in the field. It’s really great how accepting and welcoming the field doctors are. It’s always great to get out and see different offices. I recommend doing that as much as possible!

On Friday we spent most of the day looking at houses. Everything is happening so quickly! I can’t believe it’s already time to do all of this. We looked at some really interesting properties, but we found one we really like. Everything seems to be falling into place. I am ready to get out there and take in everything I can. The precepting program is a really great opportunity, and I am so thankful to be able to get this experience.

‘I know this is going to go terribly’

Nerve-wracking

Nerve-wracking

So I mentioned that I took the clinical OSCE, and after you’re graded on it you have to go through and review your tapes and watch yourself perform the exams. This happens a few weeks after you take the exam, and so I had my OSCE review a couple weeks ago and it just seems so weird watching myself. Those awkward silences were just as awkward in the video as they were in the room that day.

Overall, though, I was pleased with how I did and I think I did quite well. I noticed a couple of things that I forgot to do. I was sort of dreading having to watch myself because I was thinking, “I know this is just going to go terribly.” I didn’t want to see myself being all frazzled trying to get through this test. At the time, you’re not sure if you’re acting awkward or not because you’re nervous about taking the test, and I just really felt like I would get in there, watch myself on the tape and see that I was just doing terribly.

Luckily, that was not the case. It turns out I actually know what I am doing! And I have learned quite a bit while I’ve been here.

-Allisha

What I did on my winter vacation

This is the trimester with our holiday break, which always makes the trimester feel super long. This break was nice because we got about two weeks off, and, being in a higher trimester, we didn’t have anything to study for over break and didn’t have a lot of homework. So I just got to relax and enjoy my break.

I remember in lower trimesters hating this break because there was always so much to study for over break and not wanting to study–because I wanted to spend time with family and do holiday things.

This break I did a bit of traveling around spending time with family. The first part of the break, I went to visit a friend in Minneapolis for a few days, just to get away and relax. On my way back from there, I stopped in Ames to visit my cousin then headed back home to spend a few days with the family. Then I went back to Ames so I could get a bridesmaid dress for my cousin’s wedding. Then I went back to Minneapolis for the New Year.

I ended the break by going to see Trans-Siberian Orchestra in concert at the iWireless center in Moline (right across the river in Illinois) the Sunday before classes started up again. It was a great show this year. This was the 11th time I’ve seen them in concert, but this year was the first year I had floor seats. We were in the 8th row, and it was an amazing way to end my break!

I spent a couple days in Davenport somewhere in there to get my homework done. I seem to work better in my own element, so I knew I would have to spend a couple days at my apartment or I would never get my work done. It was really nice to have a relaxing break with a bit of traveling and getting away before things pick up. Then when I got back to school in the New Year, I was able to start seeing outpatients, which was a great way to start the new year!

It’s clinic time!

Student adjusting in the clinic

In the clinic, students adjust patients under the supervision of a staff doctor.

Right before break, we officially cleared for the outpatient clinic in the AHC (Academic Health Center). We had two days to be in the clinic before we left for break. I spent the first couple days and the week after break just observing other interns taking care of patients, so I had a better idea of what to do when it came time for me to start taking care of patients.

There are quite a few differences between the two clinics. In the AHC, we have Medicare, Medicaid and insurance patients, which means there are certain ways the paperwork needs to be done and filed that is slightly different then how we did things over in the student clinic. I wanted to make sure I had most of that figured out first.

Since we’ve cleared, I really just spend most of my time in the clinic seeing patients. Since I’m still a new intern, I don’t get to see very many, but I have been able to take over a couple patients and it has been an awesome experience.

In the CHC (Campus Health Center, the student clinic), our patients are primarily Palmer students, so most of them are wellness patients or have a general understanding of being healthy. So we don’t see a lot of patients with problems. In the AHC, you have patients from the community coming into receive care because they have problems. It’s really cool to get the different experience and start working with outpatients.

So that has been keeping me busy. We have fewer classes during this trimester so we can spend most of our time in the clinic. It has been a couple weeks, and I think I’m finally getting the hang of things!

As the trimester ends, I suspect things will pick up and we’ll start to get quite busy. With not having as many classes this trimester, I find myself with more free time than I’ve ever had before–so that’s been a pretty big adjustment. I feel like its been well-earned, though it’s nice to not have things to do constantly. So I assure you, it does happen!

Except Boards are right around the corner again, so it’s back to hitting the books again real soon!

Clinic rotations get us ready for outpatient care

Dr. Marriott and a student intern with a patient in the AHC

Dr. Marriott and a student intern with a patient in the AHC

We have several rotations we have to complete before we are able to clear for the AHC (Academic Health Center clinic) and start working with outpatients. Those are radiology, rehab, outreach and front desk. We also have to observe several adjustments under the staff doctor we to which we are assigned. We do the rotations so we can get a feel for all of the departments we will be going into. Last week I did my radiology, outreach, front desk and clinic II rotations. The only one I have left to do is my rehab rotation.

First I had my radiology rotation. We went down into the AHC radiology department, got a tour and got to see how the machines worked. They are a bit different from the CHC (the student clinic, the Campus Health Center) X-ray machines so we got to move them around a bit and just see how they work. I am glad we did too, because today I had to take impromptu X-rays down there, and I am glad I knew how to work the machines.

We then got to look over some films and go over some cool or unusual cases that had come up through the clinic system, which was good practice. We finished up the last part by sitting in on Dr. McLean’s X-ray reading for local field doctors. This part was really awesome. It was great practice and exposure to reading X-rays, and Dr. McLean was really helpful in answering our questions and helping us just read the images better.

After radiology rotation, I sat in on the front dest rotation. This is just getting some extra exposure to what the ladies at the front desk do all day. Let me tell you, it’s a lot more than scheduling. They are all in charge of bigger projects that need to be done each day and sorting through paperwork and billing, on top of the demands of the interns to get patients scheduled and to check out equipment. Don’t take these ladies for granted! And be patient with them. They are wonderful and do a lot for you.

The last rotation I went to was in the outreach clinic in Davenport. It’s located on 6th and Harrison and is available for patient care for people who can’t afford care. From what I understand there are guidelines to qualify for care at this facility, but it’s a great asset to the community and it allows the students to help out in another clinic setting. It was a little slow while I was there but picked up and got pretty busy at the end of my shift.

I really enjoyed all of the rotations and observations I did and thought they were a great learning tool. I was really glad we had to do them before we get over into the outpatient clinic. I felt like it better prepared us for what we have to do and gave us a better idea of what our options were for the coming year.

-Allisha

I survived OSCE exams

Hang in there cat

Hang in there cat poster

I had the first part of my OSCE exams this week. In our 8th trimester, we have to take two exams that allow us to go onto Level II clinics and eventually graduate. One portion is a clinical aspect where you go in and perform a full evaluation on a mock patient. The second portion is a radiology portion. I had to take my radiology portion this week. It’s done on a computer, and we’re given 10 different cases with films then asked questions over the cases. Then we have to identify what the most significant diagnosis is and how we would manage that patient’s care.

It wasn’t so bad. I wish I had studied more, but life calls sometimes and you just run out of time. I don’t have to take the clinical portion until Dec. 4, so I’m going to start studying for that soon so I am more prepared for that one than I was for the radiology portion. Really, though, these two exams have been all I’ve really had to study for this trimester so far, so I’d say that’s not bad at all.

It’s weird going from having to study every night for multiple exams to only having to study occasionally for a couple exams weeks apart. So it actually does happen! You won’t always be swarming with exams. Don’t get me wrong, we are still very busy but it’s a different kind of busy, a better busy. I would rather be taking care of patients in clinic than studying constantly and sitting in class all day.

So it does get better, I wouldn’t say easier, I would say better with a different kind of busy. It will all be worth it in the end, just keep at it!

-Allisha

My first set of X-rays

stock X-ray image

Random stock X-ray to avoid HIPPA issues 🙂

Last week, I had a week full of radiology. I got to shoot my first set of X-rays. We did a Palmer upper cervical series and a lumbar series.

It was fun to actually be able to get in and take the films. In class, we do the set-ups a lot, but we aren’t able to take films on an actual patient. It’s easy to shoot an X-ray on a phantom, they don’t move at all!

Our patient kept leaning to one side, so we kept having to reposition him so he would be centered in the film. After we took the films, we had to write a radiology report on them. We had to use the actual films for interpretation because the program we use on the computers wasn’t working that day. Then the next day we had to go to a radiology reading to make sure we didn’t miss anything on the film.

It went really well. Our diagnosis was right, and there wasn’t really anything we missed. We just didn’t word things well on our report. It wasn’t too bad, though. We were lucky our first experience wasn’t traumatic. Sometimes you hear horror stories about radiology review, but there was nothing like that for anyone that was analyzing films while we were there. I think some people must not be prepared when they go in there. Just be prepared, know your patient and do your best. You will come out all right.

-Allisha