Dex's Blog

Hello everyone, and welcome to my penultimate NUHS blog. Yes, I know it's going to be very sad when I am longer writing about my entertaining weekends and insightful blunders with patients, but I am sure you will be able to press on. 

FSU vs. UF Game (Click photo to see full version)

Speaking of pressing on, I had to walk into the clinic this morning with my head a little lower than I would've liked. I, as some of you may know, am a huge Florida State Seminole fan. I love my alma mater and have stuck with them through thick and thin, and after this weekend, it will be no different. After a fantastic Thanksgiving Thursday, my old roommate and best pal, Rich, made the drive up to Tallahassee for one of the largest and long standing in-state football rivalry games--FSU vs. UF. It felt great being back in my old stomping grounds and hopes were high that we would best the Gators. Unfortunately, our hopes were deflated, as we lost a disappointing 37-26. To add insult to injury, my Tampa Bucs also lost a close match up against the now 10 and 1 Atlanta Falcons. I was not a happy camper last night, but some left over turkey, ham, and casserole did help a little. 

Being disappointed in sports is one thing, but what happens when you become disappointed when treating a patient with no results? At what point do you have to step back and realize that you may not be able to help a patient? Then once you have made that realization, whom do you send them to?

I have been writing mock narrative reports for the past week and came across one of my old cases in which this happened. I took over this particular patient from a graduating intern, who had been treating her for lower back, right hip and right lower leg pain. We had established that the patient had lumbar spine disc derangement, decreased core stability from two cesarean sections, and peripheral nerve entrapment of the peroneal nerve in the right lateral compartment of the lower limb as well as a pretty substantial gluten allergy. This patient was treated 2-3 times per week depending on her schedule, and would find mild relief after treatments, but after two months at this frequency she was still not experiencing any lasting relief.

At this point I reevaluated the patient and began another course of treatment. Prior, the patient was being treated with Cox Flexion and Distraction. I then switched to McKenzie end-range loading techniques (more extension-type therapy), which seemed to offer longer lasting relief. Still a month went by with very little change. Now, I started to pull my hair out. At that point I had to have "the talk" with my patient about possibly finding another treatment option. She was very apprehensive to any kind of injection or surgery, which is understandable and very common. The challenge then became finding another alternative to her care that would benefit her and she would be comfortable with. Together we decided that seeking out an established McKenzie certified practitioner might help, as I am not totally comfortable with some of the more advanced stages of McKenzie protocol. A month or so went by before the patient called the clinic, but when she did it was with good news and she was extremely happy that we made the switch.

I never looked at the situation as a failure on my part, or that I was losing a patient, because in the end something I did made her better. This should always be the goal as a doctor. Money will come and go, as will patients, and as stressful as it might be to keep your lights on in practice, you have to be able to sleep at night also. This patient ended up continuing to be treated by the other practitioner, but she did refer her husband, who is still an active patient.

I hope everyone has a quick and productive week. Everyone should be studying for finals already. Studying early always helps with the crazy amount of exams stacked in a two-week period. Make the final push of the trimester a good one.

Catch ya later,
Dex

Good morning all. I hope everyone down here is staying dry. We've been in the middle of Tropical Storm Debby all weekend. Half of Tampa was under water all weekend and parts of Pinellas were out of power, but here I am bright and early sitting in clinic hoping my appointments show up.

Despite the weather, my weekend turned out pretty darn entertaining. Saturday, my pals and I were at our local soccer bar rooting on La Furia Roja ("The Furious Red"), the Spanish national soccer team, against France. The match ended 2-0 in favor of Spain, and the celebrating didn't end till early Sunday morning. The rest of Sunday I had to suck up my mild nausea and headache and entertain family from Tennessee that I hadn't seen in about a year or so. The great thing about seeing family that you haven't seen in a while is all the questions about how and what are you doing now (can you sense my sarcasm?). Being the glass-half-full kind of person that I am, I found the silver lining and took this as an opportunity to hone my rant on what chiropractic is, and how I plan on utilizing my new found skills once I graduate in another few months.

The questions I was asked by family are questions we as chiropractors will face all the time from other health care professionals, prospective patients or skeptics. It is important to have a confident and intelligent answer to offer when this situation eventually occurs, if it hasn't happened to you already. So what do I say when I'm asked what it is that chiropractors do? I like to say that I'm a doctor (or will be one) who takes a look at the patient as a whole, and treats them as such. I'm not against the use of medications and some other allopathic treatments, because in some instances they are warranted. I prefer to treat the underlying source of a patient's discomfort in a non-invasive manner. As a chiropractor, I am almost expected to concentrate on the musculoskeletal aspect of pain, which I have no problem with it, but as an NUHS graduate I will be trained as a primary care physician and will practice in that manner. I always end with asking the questioners to come and have me evaluate them to see for themselves what it is I can do for them. I guess you could call that my "elevator speech." Believe me, as cheesy as it sounds, everyone should have one, and it should roll off the tongue.

Well, enough of my rant. I hope everyone has a great week and for those of you taking midterms, best of luck. Hopefully everyone has been keeping up with their material so the tests don't seem that daunting. Remember you usually know more than you think you do, so try not to let the nerves get to you too much.

Good luck on midterms,
Dex

Hello, everyone. The end is near; I can see the light at the end of the tunnel getting closer and closer. This trimester has flown by. I'm not sure if it was board exams in the middle of the tri, or making the shift to clinic, but I can't believe there are only three weeks left. We all have to make the final push here soon, so gear up for a strong finish. 

Last week I spoke with an incoming student, and he asked me why I chose National over the other chiropractic schools in the country. I answered that it was the right fit for me. Making a decision to attend a program like the one I'm a part of took some planning and research, after all, the choice ultimately affects the rest of my life.

The prospective student should do their homework when they are looking at schools to attend. I had always wanted to be a dentist, when I realized that choice wasn't the right one for me, I had to do some serious thinking. I began shadowing everyone I could in the medical profession. I knew I wanted to help people, I just wasn't sure how, or to what capacity. After sampling the allopathic profession, I took a look at the alternative aspect of medicine and shadowed my cousin, Dr. Valdez, a chiropractor out of Brandon, Florida. Obviously, that is where I found my fit. Realizing what kind of doctor I wanted to become, was step one; step two was choosing were I would sacrifice the next three-plus years of my life.

This step took some time to work out. I started off researching exactly what was "chiropractic" and then who taught it in a manner I would understand and make sense of. I found I leaned toward a more "mixer" mentality of practicing chiropractic, as opposed to a "straight" chiropractic style. Granted, to an extent, schooling is only as beneficial as you make it, but putting yourself in the correct place to succeed, makes a world of difference.

At this point I started looking into different schools, their philosophies on chiropractic, and the opinions of practicing doctors in my area about those schools. After taking all these factors into consideration, I settled on NUHS. The emphasis National places on evidence based practice and the scientific proof behind what it is we do as chiropractors sold me. In hind sight, I would make the exact same decision again. The decision is always yours, and the more informed you are the better. I'm not saying National is the perfect fit for everyone, but if you're a prospective student, at least give us a look. 

The two-week break is almost here. Do your best to stay focused and knock out those finals, and then it's time to party. If you're worried about finals, and need a study plan refresher, take a look in the past blogs for my awesome three-tiered study plan; it may help.

Have a good week,
Dex

Good morning, blog reading faithful. Hope everyone's week went well last week, and the weekend provided some downtime from all the midterms. I know around here students have been scrambling to get in any last minute studying they can. Cramming doesn't always work in the long haul, and I'm not endorsing it, but it can help in the crunch.

A student approached me last week and asked how to find the time to study appropriately. The best answer I could give was to study every day. I know it's the absolute last thing you will feel like doing when you get home after a full day of lecture, but it's the best way to avoid that overwhelming feeling before a test. An hour of reviewing notes right when you get home will go a long way in understanding material and mentally storing that information.

Shelby studying outside the Annex building in between classes

So this past Saturday, I was out to dinner with some friends at the Refinery in Tampa (killer restaurant, by the way), and out of nowhere my pal Javi put me on the spot and asked what exactly is it that chiropractors do?

A few of my buddies' parents are MDs, Javi's dad is pediatric surgeon, and to them chiropractic is some monster living in the hillside handing out strokes to the scared townspeople. The question of what it is we do as chiropractic physicians will tend to come up quite a bit in networking circles and in practice, so one should be prepared to tackle it.

Getting back to the story at hand. There I was at the dinner table with 5 other of my friends staring at me and expecting me to enlighten them to what I've been doing with my life for the past 2 plus years. Luckily I had an answer for them (and I'm a good BSer).

"As chiropractors we use a lot of the same diagnostic tools as MDs to reach a diagnosis of what's ailing our patients, with an emphasis on approaching the patient as a whole, then treating the patient using a drug-free, hands-on approach." It was a short and sweet answer that I thought would suffice, but then came the question, "I thought you were just a back guy?"

Katie adjusting Guy

I don't about you, but I can't stand that statement, however it's a conception the majority of lay-people have about DCs. I answered, "Some chiros are solely 'back guys.' I think of myself as becoming a doctor who can treat any part of the body, but whose treatment, more often than not, can consist of spinal adjusting, but doesn't always need to." This was followed by some more questions, answers and scenarios, but the point is, I was prepared.

As chiropractors, we will be asked these questions, and we must be able to defend our profession in an educated and articulate manner. Have your own definition of chiropractic handy for patients, and another for networking with allopaths. It's inevitable that someone will try to stump you with this question; don't let them.

That should be enough story time for this week. I hope everyone has a great week, and it flies by. For everyone studying for boards on the horizon, don't stress yourself out; you'd be surprised how prepared you are even if you don't realize it. When in doubt, a beer (or 2) while studying tends to help.

Catch ya on the flip-side,
Dex

Good morning, and Happy Monday. I'm coming off of a good weekend and I hope everyone is doing the same. The Tampa Bay Lightning came away with an overtime win on Friday night, my FSU Seminoles put a beat down on Boston College Thursday night, and I had a couple of fantasy football wins, so I can't complain.

Even with all the great sports on this weekend, I did manage to get some good chiro-practice in this weekend. I'd like to think that I'm pretty good at different exams and orthopedic tests that I've learned over these past two years. Unfortunately, as I realized last week, without practice those skills can quickly head down hill.

I performed a lower back and lower extremity assessment on our very own Dean of Academic Assessment Chad Maola, last week, and needless to say there was some room for improvement. This exercise made me realize that with all the material we are constantly learning, some of our more basic practices can fall to the wayside. We all tend to forget that we are in a graduate program, and we are expected to master all the techniques and information we are given, whether it is in the classroom or on our own.

To help sharpen those skills once again, I took some time this weekend performing all my basic exams on anyone and everyone I could get my hands on. Take the initiative and find a professor that you feel comfortable with and at lunch one day, ask them if you can perform some tests on them--guaranteed they will be thrilled to make fun of you until you get it right.

Dr. Stark demonstrating shoulder taping on Guy.

Last week was very sports-oriented in our classes. Dr. Tim Stark, our in-house functional assessment and rehabilitation guru, helped us out learning some different taping techniques. For the future docs that are looking to break into the sports aspect of our profession, being proficient in taping is a huge tool to have on hand. In an hour of lab, each of us in class burned through a roll and a half of athletic tape learning how to stabilize shoulders, ankles and wrists. The end result of the class was not only a loss of a lot of my hair on tape, but a much better appreciation of a complicated technique that can work wonders if done correctly.

Hopefully, today's blog inspires some of you to keep practicing and keep learning. Being a part of the medical profession means we will be students the rest of our lives in one capacity or another, so continue to keep your minds open.

I hope everyone's week goes well and flies by. I'm already looking forward to the weekend because the weather down here in Florida has been too nice to spend inside.

Take care,
Dex