Clinic Abroad in India: Part 3

Blogger’s note: This is the last of three entries about my recent travels during a Palmer Clinic Abroad trip to India, abridged from my journal.

Our first day of clinic at Al-Arif Hospital had been advertised as a “free chiropractic medical camp,” and anyone could register. We saw a huge variety of people, from old to young, and rich to poor. It was a lot different seeing adults than it was seeing children.  As efficient as I tried to be, people had so many complex issues that it was impossible to move quickly.

I saw many bilateral, radiating pain cases that I referred to the medical doctor. I don’t think he did anything for these patients other than prescribe pain meds, though. I only ended up seeing 13 patients this day. We were instructed to hand out our clinic cards to lots of patients, and to encourage them to come back. I was hopeful of seeing some of them again.

Day two of the hospital clinic went a lot better than day one. I adjusted 32 patients. Some were repeat patients, and I was pleased to see that many of them were holding their adjustments.

Some of them were getting relief, but some of them were not. That was frustrating.  A lot of the people had chronic problems that one or two adjustments probably wouldn’t help much.  I gave them home exercises they could do and told them which activities to avoid.

Day three was supposed to be all repeat patients, although we had some new ones, too.  I continued to see improvement in some of my patients.  We were able to get some boys from a local Islamic school, and they were a lot of fun to adjust.

Now that I have spent a couple of days doing adults, I realize how quickly you can get through the kids. I wish we had saved the school for last, because we could have cruised!

I think a lot of the boys thought I was pretty because they would giggle and blush around me. One brave little boy of about six looked up at me and said, “You’re beautiful!” It was pretty cute.  I’m definitely not anything special, but they think anyone with white skin is beautiful. It was a good boost to my self-esteem. I adjusted 31 people that day, for a total of 134 for the trip.

When I went on clinic abroad, I had hopes of changing lives with my adjustments. We all hear the miracle stories of children being carried in and walking out, or patients with a lifetime of pain that is reduced in one adjustment. Of course, while those things do happen occasionally, they are rare cases. I was able to help some people, but many I was not. And the majority of the people I adjusted, well, I will never know whether my services helped because I won’t have a chance to follow up with them.

What I didn’t expect was that the person I would help the most would be my interpreter. She had confided in me that her family abuses her. I reported it to one of our trip coordinators, who looked into the situation more. I found out she has a mild mental disability, and that she had made some choices that her father and grandmother don’t approve of. These choices re big “no-no’s” in their culture.

I hope she is able to regain their confidence in her and have a better future. Based on her progress while I was with her, I think she may be able to do so. She ended up being such a good assistant. She matured so much during the week we were together. She went from being shy and nervous about doing a patient history or exam, to being able to do pretty much everything on her own, except the adjustment. She also improved her English immensely and was much more outgoing. She was so helpful, always willing to assist when I needed her (“Yes, ma’am!”), taking initiative, and never complaining. I realized how important this experience was for all of the interpreters, and how much more prepared they will be for being nurses.  It was very hard to say goodbye to them.

The day after our last clinic day we left for home, a trip that took over 32 hours from the hotel in India to Palmer in Davenport. Coming back to the United States made us realize how many blessings we have here. Even the dirtiest places of Davenport seem very clean now, compared to the nicest places of India.

I am so glad I had the opportunity to experience another culture in such a personal way, by getting to know the people there and contributing to their health.  It was an experience that has helped me to become not only a better chiropractor, but also a better person. I will never forget it.

Alissa Grover
9th trimester student, Davenport Campus

Clinic Abroad in India: Part 2

 Blogger’s note: Following is the second of three entries about my recent travels during a Palmer Clinic Abroad trip to India. It is an abridged version from my journal. Enjoy!

After a few days of sightseeing in New Delhi, we flew to Hyderabad, which is a large city located in central India.  We stayed at a hotel called the Taj Krishna, which is a beautiful, old-fashioned style hotel. We got to meet our interpreters, who are all female nursing students, and give them instructions on how they can help us.  Some of the interpreters had done this in the past, but mine had not.  She was a sweet, but shy, girl and I hoped that she would open up to me more as the week went on.

The next day, Thursday, was our first day of clinic! We went to St. Anne’s Christian School, which is an all girls school. When we got there, students were all lined up in the courtyard: several thousand of them. They had a really nice opening ceremony for us. Some girls sang, other girls danced, their band played, and they gave us all flower leis. It made me cry! Then we got to work.

We were in a very simple classroom with an open window to the busy outside, and Clint (my husband) commented whenever he came in that the exhaust fumes were bad. I must have gotten used to it. I felt that I was moving pretty quickly that day, although I only ended up adjusting 23 girls. We didn’t have a whole lot of clinic time. We went from about 10-3 with a break for lunch.

Day two of clinic was much more efficient. I started to move faster and was able to adjust 36 girls. The fun thing about working with kids is that they don’t usually have any pain, so they are considered “wellness” patients. You pretty much just adjust what you find without having to worry about any complex conditions.

I did have one girl with ankle pain that I got a really good talus adjustment on. It went “pop!” which startled her, and she said it felt much better after.  I also had a girl with low back pain, and she had a pretty bad thoraco-lumbar junction subluxation that also adjusted very easily, and she also felt improved. It was sad to pack up and leave at the end of the day. It was hard to get from the school to the bus. We were all attacked by swarms of “paparazzi”—the girls all asking for our autographs before we left!

On Saturday we had a free day, and a group of us went to Charminar, which is a large shopping bazaar in Hyderabad.  We ended up spending the majority of the day there, and I purchased a tailor-made sari and kurtha (a type of women’s dress suit) for myself and my sister. We also purchased an ethnic Indian outfit for my husband.  It will be fun to have those to wear to costume parties or out to Indian restaurants in the states.

I think my favorite part of this day was riding the auto rickshaw. Traffic in India is crazy! The only traffic law is to stop at a red light, and they don’t have many lights. In general they drive on the left side of the road (British style), but lane lines are just a suggestion. They basically use the rules of walking for driving. Crossing at intersections and turning were pretty interesting. They just weave in and out of cross traffic like a game of Frogger.

The rides were also a way to see more of the city. There was a barber by the side of the road, the little stands where rickshaw drivers would buy gas in plastic bottles, and water buffalo wandering by. The worst part was the exhaust and polluted air rushing into your face.

The next three days we had a clinic in a hospital called Al-Arif.  Stay tuned for the third (and last) part of my tale.

Alissa Grover
9the trimester student, Davenport Campus

Clinic Abroad in India: Part 1

Blogger’s note: This is the first of three entries about my recent travels during a Palmer Clinic Abroad trip to India. It is an abridged version from my journal. I hope you enjoy it!

After an entire trimester of preparing, we finally left on June 16 for a 12-day trip to India. A total of 30 students from the Davenport, Florida, and West campuses are on the trip, with 4 faculty doctors, one of whom is my husband!  (Lucky me!)

We took a bus to the Chicago O’Hare airport, then flew to Delhi with a 2-hour stop in Frankfurt, Germany.  It was supposed to be a nonstop flight, but Air India is having a strike right now and their employees won’t do trips over a certain length. So we did a re-staffing, re-stocking, and cleaning stop. 

The only unfortunate thing was that we were not allowed off the plane, and it added several more hours of travel time. Our total time on the plane was somewhere between 17-18 hours. Thankfully, the plane had plenty of leg room, personal TVs at each seat with lots of movies to watch, and excellent food. We were served a dinner, breakfast, lunch, and then another dinner on the flight, and it consisted mostly of Indian food. It was nice to sleep and watch movies and eat, and the time went pretty quickly.

We arrived in New Delhi about 7 a.m. their time, which is 10-1/2 hours past Central Time.  Needless to say, it was a relief to get off the plane, gather our things, and take our first step onto Indian soil: hot Indian soil!  That day it had reached around 110 degrees, and the ground was still radiating heat, even though it was getting dark out.

It seemed to take almost an hour to get to the hotel because traffic was so crazy!  People drive on the left-hand side of the road here, like in England, but it is seriously a free-for-all. Lanes are just a suggestion.  Cars, rickshaws, bikes, motorcycles, people, dogs, all on the road and honking and going every which-way! We saw one motorcycle with a family of five or six on it—none with helmets, of course—and the youngest being no older than 2. There were lots of people walking around everywhere, and people sleeping everywhere.

Upon arrival to our hotel, we were greeted with fresh fruit juice and another dinner. We definitely were well-fed!  Our hotel is really nice—a 5-star, European-style, very modern and hip-looking place.  The food is fabulous, and the dessert bar is like a dream come true. My plate usually consists of about half food and half desserts, and then I eat several pieces of naan. Yum!

Our first day in India, we did some guided sightseeing and a city tour of Delhi.  There were lots of old historical buildings, some medieval-period ruins, and mosques. We got to walk around in one large mosque, which is a place of prayer for Muslims, and we had to wear booties on our feet and wear long-sleeved, floor-length dresses to cover our skin. The men wrapped a type of sheet around their legs.

There were many homeless people just sitting around and sleeping inside the mosque, and we saw many beggars. Then we saw the memorial where Mahatma Ghandi is interred. It was part of a big, beautiful park with lots of greenery—a nice respite from the busy city.  We also drove by “Old Delhi”, which is the older district of Delhi. It looked like an extremely run-down and over-crowded version of the New Orleans French Quarter.

Our second day in India, we took a 2-hour train ride to Agra, a city that is southeast of Delhi.  Our destination in Agra was the Taj Mahal, probably the most well-known landmark in India. The Taj Mahal was built by a previous ruler of India as a mausoleum for his beloved wife, who died giving birth to their 14th child.  It is even more magnificent and beautiful in person than in any photograph.  There are no visible buildings, wires, or other indications of modern development surrounding the Taj Mahal, so you feel as though you have gone to another world. We spent several hours walking around the grounds and inside the Taj Mahal.  There were many Indians here who asked for us to take pictures with them. It is a big honor for Indians to be in photographs with Americans. They believe it will bring them good luck, so we found ourselves posing with many of them. It made me feel like a celebrity!

After the Taj Mahal, we visited a marble craft shop where they make beautiful hand-crafted table-tops, chess sets, vases, wall hangings, and many other things by inlaying precious stones into marble.  We got to watch them work and also had the opportunity to buy pieces.  They were very expensive, but a few members of our group bought small tables, and my husband and I bought a small piece of marble with an image of the Taj Mahal inlayed with mother of pearl.  Next we went to a carpet-making shop for the same opportunity.  Our day ended with a dinner and magic show at an Indian restaurant, and then we made the 2-hour trip back to Delhi.

The day after our trip to the Taj Mahal, we flew to Hyderabad, a city in the central part of India.  That’s where we spent the rest of our trip and had our clinic.

Please stay tuned for my next blog for the continuation of my tale.

Alissa Grover
9th trimester student, Davenport Campus

Experience all four seasons in Davenport

A lot of people complain about the weather in Davenport, and having grown up here, I will agree that it has its disadvantages. However, it also has a lot of advantages, too.

I absolutely love the Midwest in the spring. It is my favorite season of the year. The temperatures start to warm up, it’s still a bit cool at night but not too cold, and everything starts to turn green.

My husband and I recently did a lot of gardening around our yard. We planted flowers, bushes, and a vegetable garden. Things grow very easily around here because we get a decent amount of moisture throughout the spring and summer, and our dirt is very rich with nutrients.

My husband grew up in Utah, and if they don’t irrigate daily, things dry up very quickly. This past weekend I was in Dallas for a class, and already the grass that wasn’t being irrigated was starting to turn brown. The grass in Iowa is full, rich and green. If I were a grazing animal, I would be in heaven!

I have been enjoying going running with my dog, through the neighborhoods and on the bike path, and looking at all of the pretty flowers and plant life. This is a good time of year for being outside because the temperatures are so ideal.

During the summer, it can get rather hot in Iowa. It’s not uncommon to get up to 100 degrees–or sometimes higher—during mid-summer, and the humidity makes it seem worse. But things continue to stay pretty and green until late summer and early fall.

Fall is a season of more nice weather and beautiful colors as the trees change, and things start to get cold in November. November through February are the coldest months. It can get bitter-cold in Iowa because of the moisture in the air. We do get snow. We also get ice, which is really more dangerous.

For those who are considering coming to Palmer for three years and wondering what the weather is like, there you are in a nutshell. You get a wide variety of weather, from hot to cold, rain to snow, and everything in between. I think that’s what I like the best about the weather in Iowa: the variety. I love having all four seasons, because there’s always something to look forward to and if you get tired of one season another is just around the corner.

Alissa Grover
8th trimester student, Davenport Campus

Helping others in India through Clinic Abroad

In about a month, I will be flying to India with a group of 30 students from Palmer’s three campuses for Clinic Abroad. I have been looking forward to Clinic Abroad since starting Palmer. I always knew it was an experience that I wanted to do, even though it is extra time, effort and money to participate.

My husband was ahead of me in school and went to Brazil in 2010. He had an awesome experience, which made me even more excited. It’s hard to believe that soon I will be going on my trip! What makes it even better is that my husband gets to come, too, as a faculty doctor.

Clinic Abroad is a program offered by Palmer that you can participate in when you are in clinic. During each of the Palmer breaks, students electing to go on the trip travel to one of many locations where a clinic is set up and they adjust thousands of local residents. Most of the people who get treated by the Clinic Abroad interns do not have access to chiropractic care, and some of them do not even have access to medical doctors.

They told our group that is going to India that for some of the people we see, this will be their first trip to a doctor and they may have many things they want us to look at and ask us about. It is hard, because you need to find a balance between helping people the best you can but also being fair to all of the people who come to be treated to see as many of them as possible. People who go on Clinic Abroad say that you learn how to be very efficient and how to have a good flow. You also have the opportunity to fine-tune your skills as a chiropractor.

Soon we are having an event called “Mock Clinic Abroad.” The students who are going on the trip this summer will bring all of our equipment (portable adjusting tables, diagnostic equipment, etc.) and practice doing work-ups on each other. I know that going through everything tomorrow will make it all feel very real. I can’t wait to go to India and have a chance to apply all of the things I’ve learned in school toward improving others’ lives.

Alissa Grover
8th trimester student, Davenport Campus

Chiropractic for Quadrupeds

Finally…finally….finally! Almost exactly 3 years after having a revelation to completely change my life and go to chiropractic college, I am learning what I came here to learn: how to adjust animals. But wait, you say. Palmer doesn’t have an animal chiropractic program, does it?

Unfortunately, no. This past weekend I flew to Dallas, TX for a four day module on animal chiropractic through Parker University. The program takes six months to complete, with one module a month covering a different area of the body. This module was the sacropelvic unit, and we learned anatomy, physiology, neurology, pathology, and adjusting techniques for the sacropelvic region in addition to covering chiropractic history and philosophy, veterinary basics, and animal safety and handling. To become certified in animal chiropractic, you must be either a Doctor of Chiropractic, a Doctor of Veterinary Medicine, or a “senior student” of either (within a year of graduating).

My class this year consists of about 30 people, with about a dozen chiropractors, a dozen veterinarians, and half a dozen chiropractic students from varying colleges. Parker is one of only three schools for animal chiropractic in the country (the others are Options for Animals in Kansas City and Healing Oasis in Wisconsin) and is the only one that is taught at an accredited chiropractic college, and that’s why I chose it. The teachers are all AVCA certified (American Veterinary Chiropractic Association) and are very good at what they do.

It was an amazing weekend, getting to work with other chiros, vets, and students to learn about something we all have a passion for. On Thursday and Friday we had lecture, which was tedious but very interesting. It was so much fun when they brought in the dogs on Saturday for us to practice palpation, set-ups, handling, and other skills. On Sunday we went to a hunter-jumper equestrian farm and practiced on horses. The weekend left me exhausted but fired up to learn more about how to adjust “quadrupeds!”

 I arrived at Parker a few hours before the seminar started, so I decided to give myself a little self-guided tour around campus. School was in session so I got to see a little what life was like for the students as they went about their day.

Parker has a very nice campus, the grounds are well-taken care of and the buildings are new and nice. I had the chance to talk to some of the Parker students, and also some students from other chiropractic colleges as well, and throughout the weekend I kept telling myself, “Wow, I am really grateful for my Palmer education.” Not to put down any of the other schools, but I did feel that I had a better handle on a lot of the material and in comparing our stories that Palmer definitely has a good program compared to the rest. Now, if only they would offer an animal chiropractic program here!

Alissa Grover, 8th trimester student
Davenport Campus

Living the dream

I finally saw my first patient in the clinic!  I was seeing a patient for a reevaluation physical, which means that they had reached the end of their care plan and we do a physical to see how they have improved since their last physical and create a new care plan based on their current status.  I have heard horror stories of interns’ first physicals in the clinic taking 4+ hours, going so long that they need to reschedule for another night, and then spending many hours and days doing the paperwork involved.  So, I was a bit wary.  My patient had an exam the next day and for her sake (well, yes, and also for mine) I wanted to be as efficient as possible.  In the end, I was able to get the entire physical done in 1½ hours!  And a good portion of that time was spent waiting for the faculty doctor to sign off on paperwork so we could move on to the next step.  The patient left, and I spent another hour finishing up some of the written paperwork.  The next day I came in and spent maybe another hour typing it up, getting everything approved with my faculty doctor, and wrapping up any loose ends.  I was done that night with everything.  Overall, I was pleasantly surprised with how smoothly the whole process went.  Of course, there are some things I could improve on, for example some of the exams I did in an awkward order (“Ok, I’m going to have you sit….now stand up and do this for me….now lay on the table so I can do this…now stand for me again…”), but that will improve with practice.  It doesn’t help that the paperwork doesn’t have the exams written in the most convenient order for performing them!

The following weekend, I did my first adjustment in the clinic, and it was a bit of a surprise.  One of my patients that I wasn’t supposed to adjust for the first time until the following week needed to do a walk in, and I was already on campus for an elective, so I met her in the clinic.  It all happened so fast I didn’t really have time to work myself up or get nervous about it.  It was an AO (Atlas Orthogonal) adjustment, which uses an adjusting instrument, and is pretty “user friendly” so it wasn’t too nerve-racking.

On Monday I saw her again, and this time we did AO again, also an Activator workup and some trigger point therapy.  It was a good experience.  I have been enjoying Activator a lot—it is very rewarding, the protocol tells you what needs to be fixed, you adjust it, and then it tells you it’s fixed.  It’s great.  I also ended up doing my first NUCCA adjustment that night—also a surprise!  I was planning on observing the intern I’m taking over for, but when she found out I had just finished the elective and could adjust NUCCA in the clinic now, she told me to do it.  I had a hard time getting the patient to clear, so she tried too but also had a hard time…that made feel a little better.  Guess it gives some room to grow!

Wednesday I saw another patient for a NUCCA adjustment, and this time it worked.  The legs went perfectly even, all of the other post checks evened out, and I was thrilled!  I think my patient was even impressed.

Within the course of one week, I’ve done one physical and four adjustments already, and let me just say…this is FUN!  It’s great to be able to finally take what you’ve learned and use it toward patient care.  I haven’t felt scared or nervous at all; Palmer really does prepare us well.  I can’t wait to do more!  Bring it on!

Alissa Grover, 7th Trimester Student
Davenport Campus

44 credit hours…yikes!

One of the most common questions I get asked by prospective students when I’m giving my tours is some variation of “What is it like taking 30 credit hours a trimester?  How do you do it?”  My answer is that it’s like being in high school again.  Most people went to high schools where they had 7-8 classes a day, about 50 minutes each, with 5 minutes of passing time in between.  Yep, that’s Palmer too.  With a few differences, of course.  They are usually relieved to hear that there’s a lot less homework and assignments at Palmer, mostly just studying for exams, practicals, and the occasional quizzes.  Not to say that you won’t be busy, but it’s definitely doable.  Lets face it; this is a graduate school program to become a doctor.  You don’t exactly expect or even want it to be easy.  But hundreds of people graduate from Palmer every year, and they got through it—so can you!

That being said, it was a bit of a shock for me when I logged onto the Portal this trimester (our school website where we can view our schedule and grades) and saw that I am registered for 44 credit hours!  That’s definitely a record setter for me.  Don’t worry, 44 credit hours isn’t “normal”, even at Palmer—12 of those hours are elective hours that I voluntarily signed up for.

During the break between trimesters I took the Activator elective, where we learn the basics of Activator adjusting.  The Activator is a handheld instrument that delivers a specific, low force adjustment (often called a “pogo stick”, “thumper” or “clicker” by patients).  It involves protocols where the doctor checks the comparative lengths of the patient’s legs while playing “Simon says” with the patient (not really, but they’ll have the patient do things like “Put your left arm above your head”, “Shrug your shoulders”, and “Push your forehead into the table”, for example).  The actions that the patient performs isolates specific spinal segments and causes a change in leg length if that area is misaligned and needs to be adjusted.  It’s a pretty neat technique and a popular elective for students at Palmer to take.

Every Tuesday and Thursday evening for the first half of the trimester I’m taking the Thompson elective, which is a technique that utilizes the segmental drop table.  Dr. Thompson was a Palmer grad who developed the table and adapted existing adjusting techniques for use with the table.  The drop mechanism increases the speed of the adjustment so you don’t have to use as high of a force.

For four weekends during this trimester, all day Saturday and half of Sunday, I’m taking the NUCCA elective.  NUCCA stands for the National Upper Cervical Chiropractic Association.  NUCCA practitioners specialize in looking at the atlas, the top cervical vertebra in the spine, by taking a series of films that allows them to analyze the alignment of the atlas and formulate a specific listing for correcting that misalignment.  The adjustment is done with the hands and is very low force.  NUCCA is one of several “upper cervical specific” techniques that believe the atlas is the most important bone in the body to correct.  The atlas surrounds the brainstem, and in the brainstem is the reticular formation, which is the control center that causes muscles in the body to extend.  When the atlas is misaligned by even millimeters, it can put pressure on the brainstem and cause muscles along the spine to contract, and thus other bones to misalign, nerves to be irritated, and symptoms to appear.  Correcting the atlas goes to the source of the problem and relieves the pressure on the brainstem, thus allowing the rest of the spine—and body—to correct itself.  There are some who find it hard to believe that the atlas is the main place in the body that can be the source of so many symptoms, but upper cervical doctors have done a lot of research and get great results with their patients.  If this interests you, I encourage you to read the book “what TIME, tuesday?” by James Tomasi about how a NUCCA adjustment saved his life.

So while Palmer keeps us busy with classes and electives, that’s one of the things that makes it such a great school.  I feel so lucky that we can learn so many adjusting techniques, not only in the curriculum, but also as electives.  In several of the electives I’ve taken, students and graduates from other chiropractic colleges have been in the classes taking them too because they weren’t offered at their colleges.  There’s something for everyone at Palmer, whether you plan to adjust full spine, upper cervical specific, subluxation-based, tonal, hands-only, with an instrument….and if you have no idea what any of those things mean, that’s okay too, because you’ll learn—after 30+ credit hours a trimester, you’d certainly hope so!

Alissa Grover, 7th Trimester Student
Davenport Campus