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
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.
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.