Personal Injury, PICO, and Patient Cases

This past week in Business Management, we discussed personal injury protection. Last week, I completed the second module of Dr. Arthur Croft's Whiplash program. The weekend seminar was perfect timing in reference to my curriculum. We discussed many of the same topics in class that I went over in the seminar. I was able to ask my professor for better clarification on some of the points from the seminar and it helped add to the discussion.

A lot of what we went over in class was similar to what was taught in the seminar and that says a lot about the program at NUHS. Doctors came from all over the country to attend Dr. Croft's seminar and we cover a lot of the same topics in our curriculum. I have heard criticisms of chiropractic schools leaving out the business aspects of practice but our program has covered marketing, management, third party payers, personal injury protection, jurisprudence, and more. We came up with a business plan last trimester and we will refine it by the end of this trimester. I am happy I took the seminar that gave me a better understanding of personal injury cases and I am even happier to be able to discuss it in class. 

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As evidence-based practitioners, we use research to assist in our clinical decision-making. We are going over the PICO process in another class. PICO is an acronym that stands for Patient, Intervention, Comparison, and Outcome. It is a template for how to ask and answer a clinically-based question. We each have to do a presentation using PICO for our class. I am presenting on patients with type 2 diabetes using chromium in comparison to metformin to improve insulin sensitivity. When I am done with my presentation I will write about my presentation and the research I encountered. 

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The PICO process is very helpful because it helps with patient management. I have a few patients in clinic on which I am using the PICO process to improve patient outcomes. A lot of conditions can be managed or co-managed with diet and lifestyle changes. We can also use supplementation, possibly chromium, to help with type 2 diabetes. The main point is I am using what I learned in previous classes and what I am currently learning in my Trimester 8 classes to manage real patient cases.

My education has helped me learn how to find the answer to a problem not just memorize information. One of the main reasons I decided to pursue chiropractic is because I didn't listen to the conventional medical model that mainly manages symptoms rather than treating the root cause of the problem. Using evidence-based medicine and a comprehensive understanding of the human body, NUHS has prepared me to not only manage patients with the information I know but find the information I need.

If you have any questions, please email me at ChristopherKotwicki@student.NUHS.edu.

Whiplash Injury - Biomechanics and Traumatology

This past week in clinic, I continued to see new patients. At the NUHS clinic, we do health physicals for the students of St. Petersburg College. The students need physicals for the EMT, firefighter training, nursing, medical assistant, and study abroad programs. The students have the option to come to our clinic for free, and we also offer free chiropractic care to all the SPC students, faculty, staff, and their families.

When I am not seeing patients, I am trying to learn as much as I can in areas that interest me. I have started reading two books on physical rehabilitation and the kinetic chain. I also have been reading through the physician's desk reference for dietary supplements and herbs.

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The first textbook written on Whiplash was co-written by Arthur C. Croft, PhD, DC, MPH.

This past week I discovered a new book I would be reading by Arthur C. Croft, PhD, DC, MPH. Dr. Croft has his PhD in epidemiology as well as a DC. He wrote multiple textbooks on whiplash and TMJ problems. Dr. Croft also wrote the first textbook on whiplash injury and has written over 350 scientific papers.

Dr. Croft also teaches a program on 'Whiplash Injury: Biomechanics and Traumatology," consisting of 4 modules and a conference. This past weekend I drove to Orlando for the seminar and it was well worth the trip. Doctors came from all over the country for the seminar but I only had a short drive from Tampa Bay. It took me about an hour and a half with traffic.

I received the textbook for module two and took my own notes during the seminar. I spoke with doctors there who game from Georgia, Texas, North Carolina, and Iowa. I felt extremely lucky to be so close one of the four locations in the nation where Dr. Croft teaches.

The seminar was fantastic! It hit on a lot of the points we learned in school such as the comprehensive history and evaluation. The review was helpful but the new information was even better. I learned about the mechanics of whiplash injury. I also learned about the neurological, vestibular, and mechanical symptoms associated with whiplash. One thing that I found fascinating was a condition called post-traumatic hypothyroidism. The whiplash can cause an injury to the thyroid gland leading to fatigue and exacerbation of other symptoms.

I am going to take the other modules and take the test for the advanced certification. Between seeing patients in clinic, I am going to read the whiplash book I received at the seminar. Each module has a corresponding textbook. These whiplash classes will keep me busy for the next year, but whiplash injuries are commonly treated by chiropractors. I am happy to have the opportunity to take these classes. We are lucky to be so close to Orlando because there are many chiropractic seminars in Orlando and it is only a short drive away.

If you have any questions, please email me at ChristopherKotwicki@student.NUHS.edu.

Lunch and Learn with the NUHS Faculty

Another week in the books and a lot has happened. Our professors collaborated and gave a "Lunch and Learn" on otitis media, an infection of the middle ear. We had Professor Sri Manavalan discuss the anatomy involved; Dr. Jaya Prakash discuss the microorganisms; Dr. Michelle Jourdan demonstrate the physical exam; Dr. Brett Martin list the botanicals and nutritional supplements used to treat; and Dr. Steven Freeman show the manipulative techniques we can use to help mechanically treat the condition. Students from all the trimesters throughout the program were in attendance. Lunch was provided by the school as well. The "Lunch and Learn" was a brief overview of what we are all about at National. We discussed every aspect of the condition.

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The faculty at NUHS each bring their own expertise to our program. It was awesome to see them collaborate and demonstrate everything that goes into understanding a pathology. I really think the way it was presented encapsulates how each pathology should be approached. This approach is how we learn it through the curriculum.

We learn about the difference between normal and abnormal anatomy and physiology. We learn about microbes and other disease-causing agents. We learn how to evaluate and test for pathology. We learn how to manage the condition through nutrition and supplementation. We learn the alternative and conventional interventions so we can educate the patients on all available options. Last, but certainly not least, we learn how to manage conditions with chiropractic manipulation.

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To summarize the lecture, Otitis Media is an infection of the middle ear canal. Anaerobic bacteria can build up and cause complications, therefore, one wants to get air into the ear. With upper cervical manipulation, we can help the Eustachian tube drain allowing air to pass through the ear canal preventing proliferation of anaerobes. Otitis media can be detected with an otoscope during an ear exam. The tympanic membrane would look inflamed as shown in this picture.

Another symptom is decreased sound during air conduction and increased sound in bone conduction. We can determine this using a tuning fork and two tests called Weber and Rinne. Goldenseal and garlic are potent antimicrobial supplements that can be used to treat the infection internally. It was a great review for the upper trimester students and a brief look into the clinical sciences for the lower trimester students. I am happy I attended it and was happy for free food as well!

If you have any questions about student life at NUHS in Florida please email me at ChristopherKotwicki@student.NUHS.edu

Staying Involved with Sports Council

When I first started here at NUHS, I was excited to join the Sports Council. National University of Health Sciences in Florida has one club that is unique to our campus and that is the Sports Council. Overseen by Dr. Carlo Guadagno, the ACA's sports chiropractor of the year, the Sports Council volunteers at various local sporting events throughout the year. Upon joining, I soon found out the majority of outreach events were primarily for the interns because they are the ones who can provide treatment to the athletes at the events. I still went to the events and volunteered in other ways, but I couldn't wait until I was an intern so I could treat the athletes. Now that I am intern, I can go to these events and provide treatment to the athletes under the supervision of a licensed DC.

Students at NUHS have minimum outreach hour requirements. Students must earn on-campus and off-campus volunteer hours. In addition to the volunteer hours, students must also obtain clinic outreach hours. The Sports Council events count as either off-campus volunteer hours or clinic outreach hours. They give us the opportunity to give back to the community more often than any of the other clubs. That is why I am staying involved in the club by attending the meetings when possible to mentor the students in the lower trimesters, review the lessons being taught, and to stay informed on the events.

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This week, the Sports Council had their first meeting of the trimester. The meeting went well. I made an announcement regarding an upcoming seminar, Dr. G discussed the schedule, they announced the upcoming events, and then the president of Sports Council took everyone through some stretches for the rest of the meeting. They even made a handout of the stretches we did.

It was a great meeting; I am looking forward to staying involved in the meetings and going to the upcoming events. The Sports Council at NUHS-Florida is just another unique opportunity at our school. If you have any questions about student clubs or student life in general, please email me. ChristopherKotwicki@student.NUHS.edu

Radiology Report Writing and the Chiropractic Radiologist

I have found that when most people think of a chiropractor or a doctor of chiropractic, they think of the traditional physician who palpates and adjusts the spine. One may not often think of chiropractors as radiologists. The fact is the doctor of chiropractic degree allows one to do many different specialties. One specialty that is offered through National University is radiology. The Diagnostic Imaging Residency/Master's Degree Program is a three-year program at NUHS that one can begin after graduation. I do not intend to go into it, but it is an excellent program.

Currently, I am in Radiology Report Writing. In this class, we must write radiology reports as if we were radiologists diagnosing any pathology on the advanced imaging given to us. It is a unique class because it is good preparation for those of us who might want to pursue a diplomat in radiology. We have two radiologists on our faculty both of whom are practicing radiology with a DC degree. Dr. Rudy Heiser and Dr. Heather Miley are both National University graduates and board-certified.

We have had a plethora of classes about reading radiology and diagnosing films so it is nice to have a class where we can practice the skills and write reports in case any of us want to pursue that specialty. In Radiology Report Writing, there is a systematic way to read films and write reports. One must look at and comment on the alignment, bone, cartilage, and soft tissue. Then, based on the findings, one has to make a diagnosis and recommendation such as referring to an oncologist due to the presence of a metastatic lesion.

Up until this point we have taken:

  • Normal Radiological Anatomy and Variants
  • Radiation Physics and Technology
  • Fundamentals of Imaging: Arthritides and Trauma
  • Fundamentals of Imaging: Skeletal Dysplasia, Tumors, Endocrine, and Hematopoietic Disorders
  • Orthopedic Musculoskeletal Imagine
  • Fundamentals of Imaging: Chest and Abdomen

Currently we are in:

  • Radiographic Positioning and Radiology Management
  • Report Writing and Advanced Imaging

That's a total of 14 credits in radiology alone and that doesn't take into account the multiple times we see films in other classes such as Anatomy or Evaluation and Management. We have to write 30 radiology reports to pass the class. We also have to take 30 X-rays to graduate. The program at NUHS is very strong in radiology, so I highly recommend anyone interested in becoming a radiologist to look at National University. I feel very prepared to read and diagnose films as well as write reports if necessary.

If you have any questions please email me at ChristopherKotwicki@student.nuhs.edu