Keep Current

Hello all. I can't believe its already Week 6! Since I've been in clinic, the weeks fly by. It's definitely a different feel once you hit your internship and classes drop substantially. I'm currently only in a radiology case report elective and Journal Club, so the study load has decreased quite a bit. The studying has decreased, but reading and learning will never end. We are part of a profession that is ever evolving and changing, and it's important to stay up on the current research to know the best way to serve our patients.

Since I've been in clinic I've realized that the HVLA (high velocity low amplitude) adjustment that we've all grown to love, can't always be applied to every patient. It's important to always have a few other techniques up your sleeve just in case, because this situation will happen to you, as it's happened to me.

One case in particular jumps out at me about a patient who is training to become a Physician's Assistant. The fact that this patient is training to be in the same profession as us, but on the more allopathic side, excited me. Traditionally, the majority of allopathic doctors I've experienced are skeptical of chiropractic, and I take it as a personal goal to show them the scientific aspect of what we do and to prove to them the credibility of chiropractic and alternative/complementary medicine. This being said, I wanted to be prepared for this patient's neck pain issue, so I went to PubMed and read up on the all the different treatment options and how effective they are reported to be.

After reading through several articles, I found a killer paper performed at UCLA that compared the effectiveness of the HVLA adjustment to spinal mobilization. The study followed 336 neck pain patients between the ages of 18 and 69 who received spinal manipulation (HVLA) or spinal mobilization for care for 6 months. The patients were reassessed at 2 weeks, 6 weeks, 3 months, and 6 months with the results showing that manipulation and mobilization have comparable results in the reduction of neck pain. Good thing I read this paper, because sure as the sky is blue, there was no way my PA patient could have tolerated an HVLA adjustment as acute as he was. Being that a cervical manipulation was out of the question, I used cervical traction and some passive range of motion mobilizations to treat his condition.

After the first treatment, there came the question, "Is there a reason you didn't 'crack' my neck? Is this going to work without it?" Without a hesitation, I blew his mind with an educated answer and even printed out the paper for him after the appointment. Needless to say, he was impressed, and has since referred me to two more of his PA classmates. Long story short, being prepared pays off, so just because you don't have any more exams to study for, the reading will always pay off.

Though I keep busy with clinic and reading during the week, as you all know, I like to make up for all the work with some good times during the weekend. This past weekend was full of sports--the Ray's crushing the Miami Marlins, Florida State Seminoles blowing past Stanford to make it to the College Baseball World Series, and the start of the EuroCup 2012 that will hopefully end with Spain raising the championship cup once again. I enjoyed sports from a bar stool, the pool, and my couch; I couldn't ask for more.

2012-06-12_bday

I would also like to wish my fellow interns, Jeff Bourguignon (pictured above), and Brandon Fields very happy birthdays; I hope you guys had a killer weekend celebrating.

GO Rays/Noles/Spain!!!

Dex