Archive for tag: classes

Grand Rounds

Top -friends2

Next week for Grand Rounds I am scheduled to present to fellow interns, clinicians and classmates. Grand Rounds is required of all interns in both Trimester 9 and 10. 

Clinical Question

You are given the freedom to present on a clinical question of your choice and my friend and I decided to pose the following clinical question: How do Clinical Outcomes Improve with Physician Education on LGBT (Lesbian, Gay, Bisexual, Transsexual) Sensitive Issues? We chose this topic based on a recent discussion on the importance of asking patients sensitive questions revolving around sexual history. As naturopathic physicians, we cannot brush over a patient's sexual history by not asking if they are in a committed relationship, having sexual relations with men women or both, or how many partners they've had in a lifetime. If we avoid these questions, we are not getting a true picture of the patient's risks for disease. 

Interesting Research

Disease types and risks can vary depending on the patient's social and sexual history. For example, lesbian patients were once told they had less of a risk of developing HIV/AIDS. This, of course, is entirely untrue. In fact, our research found many lesbian patients reported that when they were asked if they were sexually active, it was usually automatically assumed they were only intimate with males. If they disclosed they were in an intimate relationship with another female, it was assumed they never had sexual relations with a male in their lifetime. 

And then comes the whole topic of transsexuals who can exogenously inject hormones to more physically resemble the opposite sex. This comes with a whole set of probable disease developments. These are just a few of the stereotypes we dug up during research for our presentation. This was enough to spark our interest to investigate this topic further and present our findings to our fellow interns. 

Valuable Resource

During our research, my co-presenter and I visited the Howard Brown Center in downtown Chicago. Howard Brown is a health care organization that serves more than 36,000 lesbian, gay, bisexual, and transgender individuals annually. The organization provides primary medical care, behavioral health counseling, research, HIV/STI prevention and social services for all age groups. We met with Chandra Matteson, RN, to discuss our presentation to ensure we were on the right track and to gain more information from someone who works with this population first-hand. She was more than helpful in critiquing our slides and provided us with a wealth of resources. We had such a great time we took pictures with Chandra and added it to our presentation!  

Ashley _Sarah _Chandra

Unfortunately, you have to be a student or faculty member of the University to be invited to attend Grand Rounds, but I urge those who are in health care to take another look into this populations' unique set of health issues. It has been indeed proven that with training in GLBT-sensitive issues clinical outcomes are more favorable. 

Wish me luck on my presentation! I will report how it goes next week!

Practicing Minor Surgery Skills

Top -gloves

This week in Minor Surgery we got to practice our skills on replica human arms instead of pretending to suture each other! Dr. Khan, our professor, provided each of us with a foam human arm with various sized lacerations that needed to be stitched up.

First, we had to make sure the wound was cleaned so we set up a sterile field with our surgery utensils and pretended to sanitize the area to be sutured. Next we had to practice opening and closing the surgery tongs with both hands. It is much harder than you think to force your non-dominant hand to do meticulous work… I need practice!! We were each given a surgical needle with thread attached to practice suturing a smaller wound on the arm. It took me a few times of rearranging the tongs in my hand before I had a comfortable angle to begin stitching. Dr. Khan came around to be sure that we had our "patient's" arm placed in an appropriate position as many of us ended up having the arm twisted in a way that would not be possible if there were really a human attached!

Ashley -Dr Khan

After a few practice runs, I had the flow down of how to stitch, tie and cut without tugging on the wound more than needed. Dr. Khan stressed the importance of keeping the stitches evenly spaced, not pulling the sutures too tight when tying them, and using the minimum amount of stitches to properly close the wound. With so many things to keep in mind, it really speaks to the art of surgery.  

I don't see myself performing minor surgery in my future practice, however, I am sure there will come a time when I need to know how to properly clean and close a minor wound. Next week we will be practicing on larger lacerations and utilizing different techniques for closing difficult wounds. 

St. Louis or Bust!

Next week is Thanksgiving already! I am going to be taking a couple of days off from clinic so I can spend extra time traveling down to see my sister, brother-in-law and niece in Missouri. First, my boyfriend and I will be stopping off in St. Louis to tour the Arch and sightsee. Being a space nut… he would like to visit the space museum, while I would rather go shopping! We will see how this pans out! All in all I am excited to get time off to spend with my family and to eat good food!

Ashley -suturing

I hope everyone has a happy and healthy Thanksgiving!

ZRT Bowl

Top -garden

With the trimester flying by, the ZRT naturopathic medical students' collegiate bowl at the annual naturopathic convention is fast approaching! We have booked our flights to Portland and made our hotel reservations, so there is no turning back! The group of four of us who are going to participate are meeting weekly to practice for the competition. Although I am very excited to compete for NUHS, the next few weeks are going to be crazy with taking final examinations early, as we will be missing the last two weeks of school. A few crazy weeks of examinations will be well worth it once we are in Portland!

While we are out on the West Coast, we plan to shadow at as many naturopathic clinics as we can. Being so close to graduation, making connections with practicing NDs is becoming more important. We already have one shadowing opportunity set in stone in southern California. I can't wait to report back on how it goes!

Classroom

In Botanicals recently, we discussed the topic of treating cancer in a naturopathic clinical setting. This topic is particularly interesting to me as I plan to pursue further education in naturopathic oncology. The field of oncology is vast, therefore most naturopathic treatments are guided toward integrated care and supporting the body's ability to tolerate debilitating chemotherapy, radiology and surgical treatments. There are many botanical formulas that can be given to help patients gain their energy and strength back after oncology treatments and to help with the brain fog patients experience post-chemotherapy referred to as "chemo brain." The lecture on botanical uses in cancer is just the tip of the iceberg when it comes to naturopathic therapies that can be utilized as adjunctive treatment in the field of oncology.

We're also discussing oncology in depth in both Internal Medicine and Functional Medicine. I am a total cancer junkie… so I will be sure to relay any interesting information!

With about 10 papers and 3 presentations looming over my head I had better get to typing! Have a great week!

Garden

This week's photos show how our naturopathic garden is progressing.

Garden -sarah

Environmental Issues

Chemical Sensitivities

This week in environmental medicine we talked about the symptoms of chemical sensitivities. This lecture motivated me to reflect on many of the chemical exposures I encounter on a daily basis in some form or another. There are a wide variety of compounds that have been proven to cause ill health effects causing symptoms ranging from a dull headache, fatigue, memory loss, and asthma to depression, neuropathy and dizziness. It becomes clear that the hardest thing about environmental exposures is determining what symptoms are truly being caused by an exposure. It is our job as naturopaths to do some investigative work into a patient's living environment to rule a potential environmental exposure in or out. 

I feel it is important to explore our daily exposures even if we are seemingly symptom-free. If we think about the cleaning products we use in our homes - laundry detergents we use to clean clothes, dish soaps, beauty products, bath soaps - we are being exposed to a gamut of synthetic chemicals that we as naturopaths believe can accumulate over time leading to potentially catastrophic disease processes.

A symptom as simple as a chronic dull headache can be the body's way of warning us that it is being exposed to something it shouldn't be. Unfortunately, if a patient complains of a headache, the first thing on any doctor's differential diagnosis list is probably not environmental exposures. However, if a detailed history of the headache is taken, there are subtle clues that point to the possibility of an environmental exposure. When does the patient have their headache? Is it Monday through Friday while they are at work? Have there been any renovations or new carpets put in at their job or at home? When do they feel symptom-free, if ever? These questions are a few examples of ways to help hone in on where and when a patient could be being exposed to an environmental toxin and can also help in formulating a treatment.

Ways to help make your workspace or home environment "Greener":

  • Utilize plants to naturally purify the air
  • Open windows if possible to allow for ventilation
  • Use full spectrum lighting, the closest to natural sunlight
  • Clean office or home with only "green" and natural products
  • Suggest a fragrance-free policy at work
  • Allow a period for "off-gassing" of new construction sites

Sometimes it can be overwhelming to learn the many ways in which we are exposed to harmful substances - swimming at the pool, eating non-organic produce, using fabric softener - the list can get so large it makes my head spin! If we can just start to recognize our personal exposures, we can then begin to link them to our health, which is the ultimate goal of a naturopathic doctor - taking charge of your health! 

Top -zoo

Lecture Reinforcement at the Zoo

So, it may have taken me 5 years to get to the Brookfield Zoo, but I finally made the trip this weekend! Lucky for me, my friend has a season's pass and can bring a friend in free! He knows the zoo inside and out and would not let us leave until we saw everything!

I have to say I was impressed; the new dolphin show exhibit was amazing! The theme of the dolphin show was conservation of our planet by teaching the audience to reduce their waste production. This is similar to the environmental exposure lecture from last week's class.

Litter in small amounts may be tolerated and only make a few animals sick. In larger amounts, litter can accumulate and make a whole eco system off balance. This is exactly the thought process behind environmental exposures! No matter what mammal or creature you look at, environmental factors can alter their quality of life for the better or for the worst.

Aside from the lesson learned about conservation, I would definitely recommend a trip to the Brookfield Zoo be added to your list of touristy things to do while in Chicago!

Ashley -zoo -sign

Groundbreaking Weekend

Top -hands

It's official! NUHS has a botanical garden!

About 15 students showed up to partake in the planting of the garden, and with so much help we were done planting an 8x10-10 foot plot in just over an hour. Before we packed up our tools we stood around the plot hand-in-hand and took a moment to think back on all of our hard work in getting to this moment.

It was suggested by a student that for good gardening luck we should spit on the garden. I know this sounds disgusting, but it was actually really fun! Now all that is left to do is to spruce up walking paths with stones and make a sign with the NUHS Botanical Garden printed on it! We will be assigning a watering and weeding schedule this week to help with maintenance of the garden. This week I'll welcome the rain instead of wishing it away!

In the Classroom

As for classroom news, this week's topic in Advanced Manipulation class was on low back and leg endurance tests. This meant that we were subjected to performing each test to see where we fell compared to the average patient. Dr. Selby had us really sweating by doing as many squats, sit-ups and sustained planks as we could! He wanted us to be able to experience what it would be like for a patient if they were asked to perform these endurance tests. Granted, we were not wearing proper attire, most of us in summer dresses, so it was a bit difficult to perform at our highest potential, but it was an enjoyable lecture nonetheless!

Ashley -sideplank

One of our teachers, Dr. Lou, is always telling us of the importance of "living in our labs" - meaning, we should not be recommending things to our patients that we have not tried ourselves. If we expect our patients to eat healthy and exercise regularly...we should be doing the same!

In the Pool

With the weather being so nice this weekend I finally got to take advantage of the swimming pool at my apartment. A friend from home came into town this weekend so we spent most of our time relaxing in the sunshine! Being that I did not apply sunscreen liberally enough, I ended up getting a pretty good sunburn on my shoulders. Not to worry though, homeopathic Cantharis and Calendula lotion to the rescue! 

This week is full of midterms and papers… but I will surely find time to play in the garden! I will keep you posted on the latest growth!