This last week wrapped up my two-week rotation at the Salvation
Army clinic. It was an interesting experience with many patient
care challenges not seen at other clinics. The patients at
Salvation Army are part of a drug and alcohol rehabilitation
program. Along with musculoskeletal issues, many of the patients
also have associated chronic health issues like diabetes, heart
disease or liver disease.
Due to it being a holiday week, the clinic hours/days were less
than normal with a very light patient load. With it being such a
busy time of year, many patients were not able to keep their
appointments or had to reschedule.
Wednesday evening, Rob and I had to prepare a pumpkin cheesecake
to take home with us for Thanksgiving. We make the same cheesecake
every year, but when the time comes to make it we forget how long
the process actually takes. We started the preparation and baking
around 7 p.m. and didn't finish until close to midnight. There's
the prep, baking the crust, making the filling, baking the cake,
letting it cool, making the sour cream topping, and letting the
entire cheesecake set. But when all is said and done, the cake
turned out wonderful and tasted great!
Early Thursday morning we drove down to Indianapolis to spend
the holiday with family. We had a lovely day of cooking, catching
up, great food, wine, and lots of laughter. The quote of the day
came from Rob's nephew when he let us know what one website listed
as the most common topic brought up at Thanksgiving dinners.
Apparently the topic most brought up is sad stories about relatives
or family friends that most people either don't remember or have
never met. We all had a good laugh about that one.
This blog marks the last blog for this trimester. I hope I have
given some good insight into what life as a chiropractic intern is
like. I have enjoyed sharing my experiences with you and will have
lots more to share come spring 2014, my 10th and last trimester of
Have a safe and happy holiday season! Wishing you all the
In clinic this week, I am on my Salvation Army rotation. All
ninth trimester interns do a two-week rotation through either the
morning or afternoon Salvation Army clinics, and there is an
opportunity for five permanent clinic spots for your ninth and
tenth trimester clinical internship. With my new job and crazy work
schedule, I had to switch around some of my shifts, and I am doing
both morning and afternoon.
The clinics are drug and alcohol rehabilitation facilities.
National University offers physical exams, chiropractic care, and
supplementation to the residents there. As an intern rotating
through the clinic, I am in charge of "new man exams." These are
full physical exams that include a hernia exam before the residents
start work at Salvation Army. If there is extra time after the
exam, I am able to give them treatment for any conditions diagnosed
or wellness care.
This week in my acupuncture elective we covered the urinary
bladder and kidney meridians. The urinary bladder channel consists
of 67 points and begins at the corner of the eye, goes around the
top of the head, down the back and leg, and ends at the outer tip
of the little toe. The urinary bladder is a water-energy yang
organ. An imbalance in the urinary bladder meridian can cause such
psychological symptoms as habitual fear, lack of decision-making
capability and a diminished moral character. This meridian is also
great for chronic tension and pain, which may be relieved by
stimulating the flow of energy along the spinal branches of the
The paired organ to the urinary bladder is the kidney and is
considered a water-energy yin organ. The kidney meridian consists
of 27 points and starts at the bottom of the foot, goes up the
front of the leg, abdomen, and ends on the front of the chest
around the first rib. In Chinese medicine, the kidneys control
sexual and reproductive functions and provide the body's prime
source of sexual vitality, which they regard as a major indicator
of health and immunity. Weak kidney energy is therefore a prime
cause of anemia and immune deficiency. The negative
psycho-emotional attributes of this channel are fear, loneliness,
insecurity, and shock (which attacks the heart first then descends
into the kidneys to become fear). A really interesting point, KD 1,
which is on the bottom of the foot, is really good for intractable
pain often experienced by cancer patients.
It's hard to believe that the trimester is more than half over
already. Once you are in the last phase of this program, the time
really flies. All your professors keep telling you that you need to
be prepared for graduation early because even though you don't have
class work to do you are still very busy. Busy with boards, busy
with electives, busy with numbers, busy with things outside of
school, and busy with planning what you will be doing
The patient load at clinic has been steady to busy most days.
This is great for all of us interns because we are getting more
experience and a good variety of patients. Also, there are little
to no worries about finishing our numbers for graduation on time,
which is a big relief. Being in a group setting with multiple
interns and a clinician to bounce treatments off and get second
opinions is great. It also has shown to be beneficial in that
everyone has a particular treatment or therapy they are very
proficient at. So we are all able to teach and help each other out
when it comes to treatment plans and patient care. This makes for a
very pleasant working environment at the NUHS Chicago clinic.
Treatment Room at the NUHS Whole Health Center
The past few weeks in my acupuncture elective course we have
learned the lung, large intestine, and part of the bladder
meridians. In Traditional Chinese Medicine, a meridian is the
belief about a path through which the life-energy "qi" flows.
Through needling these points, you are able to either tonify or
sedate the balance of qi in the meridian. The lung meridian
can be used for conditions such as cough, chest or shoulder pain,
asthma, shortness of breath, palpitations, fever, and many more.
The large intestine meridian is useful for symptoms such as
bloating, swelling, constipation, emotional stopping-up, headaches,
stuffy nose, or musculoskeletal pain. Finally, we learned a point
on the bladder channel called BL 13, which is useful for colds,
fever, cough, or flu-like symptoms.
The rest of my downtime has been dedicated to preparation for
Part IV board exams, which are the second weekend in November. With
Part I, II, III, and Physiotherapy now behind me, I am feeling much
more confidant going into Part IV. Part IV exams focus mainly on
skills learned throughout our chiropractic education including:
radiology, physical exam, patient intake, and chiropractic
manipulation. More details to come post-exams.
October 1, 2013, was the start of open enrollment for affordable
care act at healthcare.gov. So during my down time early in
the week, I made it a point to look at the site, and get acquainted
with it just in case any patients had questions. The site is very
easy to use with the initial process involving a few pages of
information to fill out to set up an account. You can also select
the state you are in to get information about that state's health
insurance marketplace or to be sent directly to that site to apply.
The site has been running a little slow due to large amounts of
people using it, but overall it's very simple to use.
The clinic time this week flew by. We had a very busy week at
the Chicago clinic with a high volume of patients and X-rays to be
taken. Having a large number of patients is great for me as a ninth
trimester intern because as soon as the tenth trimester students
finish with their numbers for graduation, those patients are turned
over to us. That process has already begun since several of the
tenth trimester students already have some of the numbers
Even though we do not have a large amount of our own patients,
we ninth trimester interns still have plenty to do to keep busy.
Each week we are assigned to a particular tenth trimester intern
whom we help with patient care and charting. Also, any of the X-ray
patients that come in are mainly our responsibility. Any other down
time we have is dedicated to file audits, OAPs that need to
written, and research to help with patient care.
On Sunday evening, Rob and I made Halloween cutout cookies, one
of my favorite Halloween traditions, for a party we are having in a
few weeks. Every year I forget how long the cookie making process
actually takes between making the dough, rolling out the dough,
cutting out the shapes, baking, frosting, decorating, and cleanup
afterward. But it is all worth it when they are finished because
they taste and look great! Plus, throughout the baking process, we
watch one of the best horror movies, "Halloween," and listen to my
favorite Halloween themed music. If you haven't noticed yet, I'm a
bit of a Halloween fanatic. Next week, I'll be sure to include some
pictures of my decorations.
Every other week on Tuesday mornings during ninth trimester, I
have a class called Journal Club. The objectives of the course are
to sharpen the student's research knowledge and evidence-based
practice skills. The final project for the class consists of
performing a literature search and finding a paper on a topic of
interest to us. We then need to put together a presentation on the
research article and share the information with the other interns
in the Journal Club.
I performed my literature search on the topic of acupuncture and
migraine prophylaxis. The article I found was a
randomized-controlled trial in which almost 500 patients were
randomly assigned to one of four groups. The first three groups
were three different acupuncture protocols, and the fourth group
was sham (control) acupuncture. Sham acupuncture means that
traditional acupuncture meridian points were not used in the
treatment. All four groups received the same amount of treatment,
electrical stimulation, and follow-up care. The primary outcomes
included the migraine frequency, migraine intensity, and migraine
specific quality of life surveys.
The results of the clinical trial showed that the patients in
the acupuncture groups reported fewer days with a migraine compared
to the control group. There was no difference in number of days
between the three acupuncture groups. The conclusion of the paper
was that acupuncture has a prophylactic effect for migraine
headaches. It also suggested that further research into the topic
is needed. The study was limited by short follow-up periods, the
physicians were not blinded, and a small number of acupuncture
points were used.
NUHS Whole Health Center - Chicago
Clinic has been getting progressively busier week by week. The
Saturday morning shifts are especially busy. It's a great day for a
clinic to be open since some patients can't make certain hours
during the week. This last Saturday in particular, I saw seven
patients during my six-hour shift. That isn't too large of a
patient load for a regular practice, but it is in a teaching
facility. In a teaching facility, you need to check in with your
clinician throughout the patient visit, and there is a large amount
of paper work to do. The reason there is a lot of paperwork is that
the clinicians want us to be comfortable with multiple types of
forms and paperwork so that when we are out on our own we are
comfortable with charting.
• First Patients and Jurisprudence Class
• Ideas for the Future
• Part IV Board Exams
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