At the beginning of the clinic week, I presented my Journal Club
article. The point of the Journal Club is to have the interns bring
articles on treatment options for patients and discuss whether or
not we would use them with our patients.
My article was on the use of acupuncture for patients with
migraine headaches. The conclusion of the article was that
acupuncture does show a decrease in the number of days with a
migraine, and a decrease in the patient's quality of life. After I
finished with my presentation, we were all able to discuss our
opinions. We also talked about what other treatment options we
would use with a patient experiencing migraine headaches. My
current treatment plan for patients with migraines, which can be
changed per patient, includes acupuncture, chiropractic
manipulative therapy, post-isometric relaxation of the
sub-occipital muscles, and supplementation of magnesium,
riboflavin, and CoQ10.
Throughout the rest of the week, I finished my decorating for
Halloween, which is quite extensive. If you haven't noticed yet,
it's my very favorite time of the year. This included any final
touches, putting up the remainder of the decorations, more spider
webbing, and hanging my newest decoration. Every year the day after
Halloween, I check out the sales on decorations, and I buy one big
decoration to add to my collection. The decoration I added last
year was a five-foot tall hanging ghoul that I placed on my
balcony. It looks great out there, and I can't wait for people to
see it next weekend!
My newest Halloween decoration
On Sunday, Dr. Miller, several ninth and tenth trimester
interns, and I volunteered at the Bank of America Chicago Marathon.
It was the perfect fall day for the race with temperatures in the
mid-60s, which was ideal for the runners. Marathon Day in Chicago
is always a fun day because so many people come out to watch,
support, and cheer on the runners. Talking with some of the
experienced marathoners after the race, they said it's almost
impossible to get tired during the Chicago Marathon due to the
amazing crowds that come out to cheer them along.
Jeff Jones, Candace Gesicki, and me at the Chicago
Marathon on Sunday
We were in the Chicago Diabetes Project tent where we were
available for post-race care for the runners. The majority of the
runners were in a lot of pain and had very tight muscles, so we
helped by stretching and massaging as needed. I have volunteered at
the marathon before, but I haven't had as much one-on-one post-race
care. It was crazy to see how much pain some people were in, while
others looked like they could run the marathon again. I'm sure that
has a lot to do with training and experience with running. Overall,
it was a great experience, and as always it is so inspiring
watching people finish something as impressive as a marathon!
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.
In Ethical Business Management class this week, we had a guest
speaker talk to us about clinical psychology. Dr. David M. Gursky
has his PhD in psychology and has over 20 years of experience in
the field. The main focus of the talk was being open to any kind of
pysch issues that our patients may have in the future, and knowing
what issues can be dealt with in the office, and which need to be
referred out for specialized care.
Patients tend to be more open with chiropractic or other
alternative medicine physicians because we focus on the entire
person, focus on the patient in their environment, and because of
the treatment setting. The treatment setting in most chiropractic
offices has patients gowned for physical examination/treatment,
requires physical contact, and induces physical relaxation, all of
which sets the stage for patient openness. Some issues that
patients might bring up with you include marital dysfunction,
anxiety, interpersonal issues, fears, stress, etc. Since well-being
is a combination of physical, mental and emotional health, it is
very important to help your patients with these psychological
issues as well as their musculoskeletal complaints, or refer them
to a counselor who can.
Again, during my downtime this week in class and clinic, I am
continuing my reading of Dr. Vasquez's textbook Migraine
Headaches, Hypothyroidism, and Fibromyalgia. I finished the
chapter on classification, diagnosis, and treatment of headaches. I
won't bore you with the hairy details on the types of headaches and
treatment, but there were some great treatments that Dr. Vasquez
Food triggers are the cause of many headaches, especially
migraines, and by pinpointing these triggers via a food/headache
diary you are able to remove them to remain headache-free. Some
common triggers include red wine, aged cheeses, sardines, sausage,
and foods containing monosodium glutamate (MSG). These triggers
contain tyramine, nitrites or other neuroexcitatory substances that
start the cascade toward a headache.
Another big cause of headaches is nutritional deficiencies that
are so common among Americans today. The standard American diet
(S.A.D.) is composed of red meat, sugary
foods, and refined
grains. The S.A.D. is severely lacking in a lot of the
nutrients, vitamins, and minerals that your body needs daily. Some
major things to supplement with to avoid headaches are magnesium,
CoQ10, fish oil, vitamin D, and riboflavin. Other treatment options
include myofascial trigger point work, chiropractic manipulative
therapy, acupuncture, and oxygen therapy.
My partner and I
This week marks the start of June, which is LGBT Pride Month.
Here's a little history of this important month: Lesbian,
Gay, Bisexual and Transgender Pride Month is currently celebrated
each year in the month of June to honor the 1969 Stonewall riots in
Manhattan. The Stonewall riots were a tipping point for the Gay
Liberation Movement in the United States. In the United States, the
last Sunday in June was initially celebrated as "Gay Pride Day,"
but the actual day was flexible. In major cities across the nation
the "day" soon grew to encompass a month-long series of events.
Today, celebrations include pride parades, picnics, parties,
workshops, symposia, and concerts, which attract millions of
participants around the world. Memorials are held during this month
for those members of the community who have been lost to hate
crimes or HIV/AIDS. The purpose of the commemorative month is to
recognize the impact that lesbian, gay, bisexual, and transgender
individuals have had on history locally, nationally and
internationally. My partner and I will be heading to Milwaukee,
Wisconsin, this weekend to join in this wonderful celebration with
close friends and family.
• First Patients and Jurisprudence Class
• Ideas for the Future
• Part IV Board Exams
To read older blog posts, scroll to the bottom and click the "Older Posts" button.