This week went much better than last week. I am finally getting my adjusting skills closer to par for Dr. Pavalok and I was more successful this week with my adjustments, woohoo!
Dr. P has started allowing me to perform new patient physicals by myself in my office which is EXCITING! They have been going quite smoothly, except for one in which I needed to have a frank conversation with a patient about the patient’s obesity and how it is contributing to the chief complaint of low back pain. It did not go as well as I hoped it would, mostly because I am uncomfortable with calling people out about their weight but that is something I am going to have to get over in order to better serve my patients. Sometimes “tough love” is essential.
We had quite a few patients with fibromyalgia present this week and one with HIV/AIDS. We altered the care a bit for the fibromyalgia patients in that we used the low force activator to adjust them, so that we wouldn’t put too much input into their already overly sensitized nervous system and send them into a “flare up.”
We didn’t change anything for the patient with AIDS which I was happy about. In my experience, having worked in a hospital, people with AIDS are often handled with kid gloves or severely isolated out of the provider’s fear of the disease. My heart goes out to those that are treated as less than human due to their unfortunate circumstances so it was great to see that Dr. P made the patient feel like any of his other patients.
Another patient story: a while ago a patient was referred for to Dr. P for care, but when Dr. P saw the patient’s x-rays he thought the bones looked too demineralized for the patient’s age. He sent the patient out for bone density testing and found that his density was dangerously low. As a result, the patient’s primary care provider put him on a regimen of Fossamax and when we saw the patient he reported that his bone density score has improved from osteoporosis status to osteopenic status, which is great news! The patient was so grateful for the catch! And he continues to see Dr. P for chiropractic care.
We had a fun encounter this week in which one of the nurse practitioners (a highly trained nurse…basically the “doctor” of nurses) that works down the hall, wandered into the office with some pain in his scapular/rhomboid area. He started out explaining the pain he felt and then asked Dr. P if there was anything we could do for him. Dr. P explained that his description sounded like a case of vertebral misalignment and offered to adjust the NP. After adjusting him, the NP felt much better and then proceeded to ask a bunch of questions about chiropractic and its premise. The NP was very receptive to all that we discussed. It was very cool to be able to enlighten him on how we address the body and have that educational moment with another healthcare provider that was not “in the know” about chiropractic.
Other fun things that happened this week were that I was able to put in my first official notes into the charting system and I was strapped into a traction machine. Putting my first notes into the charting system was kind of intimidating because it goes into the patient’s permanent record in the VA federal database. I had Dr. Pavalock look at and okay the first few before signing them, just to make sure I wasn’t forgetting anything crucial but now that I’ve got a good template down, I am up and running with charting. Pretty sweet!
One of the days Dr. P wasn’t able to come in but he asked that I go in and read up on proper documentation. Once I was finished with that, I went down to the chiropractic therapy suit and pestered James for a bit. They use the same electrotherapy machines as we’ve been trained on at school so I didn’t ask too much about them. The traction machine, on the other hand, is something that I have no experience with so I had James give me a tutorial and strap me in. I got to experience what lumbar and cervical traction feels like for the patients, which is great. As they say, experience is the best teacher.
Outside of the clinic, it was a pretty boring week. On Friday though, my roommate invited me to a birthday dinner for one of her friends. We went to a restaurant in downtown Jackson called “Julep.” It had a nice, muted atmosphere with very good food. I tried my first battered eggplant fries which were quite tasty. I made the table giggle when I asked what grits were. Apparently I need to go to a restaurant named Table 100 to get the best shrimp and grits ever…putting that on the to do list, along with a crawdad boil.
Stay tuned for more fun adventures from the south!
Alicia Ruiz, 10th Trimester Student