Archive for tag: clinic

Welcome New Stroger Residents

This trimester, two new NUHS students joined the team at Stroger's Hospital. NUHS students Dong Ming Sung and Asim Kamal became rotating residents at Stroger's hospital this trimester. These students bring a strong skill set and knowledge base to the team.

Both students feel this opportunity is a cornerstone in their educational career. "I think this is real world experience," Dong Ming stated. "It is similar to what career life will be after I graduate. Every student in our school should participate in this great opportunity. I really appreciate that Dr. Frank Yurasek is giving us this great opportunity!"

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Dong Ming Sung, Asim Kamal, and myself

I fully agree with Dong Ming. I believe we are privileged to experience many unique patient interactions at Stroger's. We are fortunate to introduce AOM to many patients who have never experienced it. Additionally, these patients are experiencing remarkable results with the addition of AOM treatments.

This trimester, we have worked together at Stroger's for three weeks. We have already been taught many new skills and tools from working with our patients. Our clinician, Frank Yurasek, PhD (China), LAc, continuously shares knowledge and skills we haven't learned elsewhere. The learning that occurs during this residency is so rich. Many of the AOM residents feel the knowledge we gain during our time at Stroger's seems equivalent to taking many additional educational seminars. At times, we learn AOM techniques and information we hadn't even imagined were possible. This residency adds a new depth, perception, and application of AOM.

Another Trimester Comes to an End

This week marks another end to an NUHS trimester! As I've blogged previously, this is a time of endings and beginnings. Many classmates are preparing for the fall trimester. Some students are graduating. Others are deciding to begin a new adventure as an NUHS student! 

One event that happens near the end of every trimester is our clinic lottery. This is the time we sign up for our upcoming clinic shifts. It's called a lottery as it is based on seniority and chance. Groups divided by seniority enter the clinic room. Then, we draw numbers to sign up for our clinic shifts. Being a senior intern, this is a fun social time for me. 

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Signing up for the clinic shifts lottery.

When I began at NUHS, the AOM student population was small. It has grown significantly over the past couple of years. It continues to expand each trimester. As a result, I think the lottery can be a time of luck and chance for the new students in determining their upcoming schedule.

Looking back at this past trimester, I think I experienced a great deal of education in class and clinically. The experiences I had at Stroger Hospital were priceless. I feel the patient interactions along with advancements in my clinical knowledge exceeded my expectations. Being a rotating resident at Stroger's offers a new depth of understanding in patient care and application of AOM. I am thankful to be invited to continue this opportunity next trimester!

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Swans and their cygnets on campus.

I also experienced many increases in responsibilities in my home life. I was stretched by many circumstances. These circumstances helped me learn how to further balance being a student, resident/intern, mom, and more. I find it fascinating that some how everything always comes together. It seems the heaviest weight when trying to balance home life and school is my perception that they will be hard to balance. As I learned in Tai Chi, once I relax into the flow of events, everything comes together. It's when I resist or worry about them that stress prevails. So, much like "push hands," a Tai Chi exercise, when I relax into the flow everything balances each other.

Thank you for reading my blog each week! I look forward to sharing more with you next trimester!!!

Stroger Hospital

One of the unique opportunities that NUHS offers its AOM students is a rotating residency at Cook County's Stroger Hospital in Chicago. 

AOM students in their final trimester have the ability to be on the cutting edge of research and hospital treatment by being a rotating resident at Stroger. The residency brings AOM students into the hospital's pain clinic. Currently, residents work under clinician, Frank Yurasek, PhD, MSOM, and along with Jackie, a nurse in the pain clinic.

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Dr. Frank Yurasek and Pain Clinic Nurse Jackie

By performing this residency, seniors have the opportunity to learn many avenues for treating pain through AOM, generally not taught in textbooks. Patients typically experience a profound effect after receiving AOM treatments at Stroger's pain clinic. Many times, pain initially rated as 10/10 on the VAS pain scale drops down to 4 or less after receiving an AOM treatment. Additionally, most patients' pain continues to stay reduced from its original level between appointments. 

During a typical day at the pain clinic, a resident will see 6-10 patients during 4 hours. Since that is a significant amount of patients for an AOM resident in a short amount of time, the resident often treats patients using one of the microsystems of the body. In AOM, there are various regions on the body, such as the ear, that are able to treat the entire body. By understanding the mapping and function of these systems, residents are able to treat conditions such as low back pain, sciatica and knee pain by using needles or ear seeds in the patient's ear. Ear seeds are little beads that stick onto the ear and work as pressure points. The scalp is another region of the body that is a microsystem with the ability to treat the whole body.

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Me, Dr. Yurasek, and Mary Thuermer

Since I feel this program at Stroger is an incredible learning opportunity, I will be blogging about it more often. I think it teaches many things, such as sometimes the quickest and easiest treatments can make the most profound impact when treating pain conditions. 

Auricular Acupuncture Treating Pain

Happy Belated Mother's Day to all Moms!!! I hope you had a very special and relaxing weekend! Hopefully you had a day of relaxation, or at least moments of the day were filled with rejuvenation! 

In addition to celebrating Mother's Day this weekend, classes started for the new trimester this past week.   personally consider both the start and the end of each trimester a mini-celebration, as each segment of time shows the beginning or end to another chapter of learning. 

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This week I was able to see the affects of acupuncture on pain patients very clearly. While I was fortunate to be a part of treating many pain patients, one patient agreed to share her treatment with this blog. This patient is a 61-year-old female who injured her foot. She may have broken 1-2 toes, but had not received X-rays at the time of her treatment. (Notice bruising on center toe.) It was decided to treat the foot distally, which means far away from her foot. One of the most conducive aspects of acupuncture is there are many ways to treat one pathology. If it's decided treating locally is not the best option, there are still many more options for treatment.

In this case, treating the patient's foot via auricular acupuncture was determined to be the best option. The patient received five needles in the ear on the same side as the injured foot. She received a needle in the following auricular points: toes, lumber, shenmen, point zero, and kidney. These points help to reduce the pain, while also helping the patient feel relaxed. Additionally, they help treat the patient's root energy, which will greater exacerbate a healing response.

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The patient reported feeling a remarkable decrease in foot and back pain. The patient had a previous back injury worsened by the change in her gait (walk) as a result of the foot injury. Before receiving acupuncture, the patient rated the pain as a 6/10 on the VAS pain scale, 10 being measured as the worst pain possible.  After the treatment, the patient rated her pain as 2/10. I followed up the treatment with auricular seeds; they are small metal beads that stick on the patient's ear. Ear seeds are a form of acupressure that allow for continued treatment after the patient leaves the clinic. By pushing on the ear seeds, the patient triggers a healing and analgesic (feel-good and pain reducing) response. The analgesic response is much like taking pain medicine to decrease the pain. I will learn at the patient's follow-up visit, how the ear seeds affected her. 

I find observing pain patients' responses fascinating, as usually through about 5 needles, the patients have a significant decrease in pain that typically holds through the follow-up visit. This is something I could never imagined possible before becoming a student of AOM!

My Dad, My Patient

This past week, I had the opportunity to present my dad as a case study for my Senior Seminar II class. It turned out to be a transforming experience!

Before he came to class, I performed an intake and case history with him. I learned that when working with family, it was a little difficult to stay objective, as I know him well, so I had a different perception of certain things than he. With a patient at clinic, there is usually no outside reference point, so the information being given is the only information the intern and clinician learn. With family, we know what they eat, their health history and their moods, but their perception and ours are not always the same. I think I was supposed to let the patient be right in this case, but since it was my dad, I found an area of grey for us both to agree on when we saw things a little differently. I think this was a great learning opportunity for us both.

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When my dad came to the clinic, it was an interesting experience to step back and listen to the clinician and other intern ask him further questions and gather additional information. It was both difficult and motivating to see my dad fully as a patient at the clinic. Since he is my dad, I have always looked up to him, but at the same time, would do anything for him.

Once we decided on a treatment plan, we advised my dad to go into the treatment room and prepare for his treatment. He was a very cooperative patient. He is rather needle-sensitive and very in-tune to the "qi sensation" (energetic response of the needles), but handled it very well. He informed us of how he was feeling during the needling aspect of the treatment once we had placed all the needles. I felt this brought an added educational benefit.

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My dad reported a positive response to the treatment. He continued to feel the benefits of the treatment the following days. In addition to my dad's benefits and the educational aspects of this case study, this felt like a bit of a milestone somehow for my dad and me. It felt a bit peculiar at times to have our roles shifted as patient and intern, but at the same time, it felt like something expanded between us by doing so. If you have read my previous blog from last trimester, you know that my dad and I are very close and he joined me at the AOM pinning ceremony. Having a moment in time where we were patient and intern instead of dad and daughter was rather intriguing.

Learning Through Clinic

From the start of the second trimester, NUHS clinic plays a large role in facilitating our education. Clinic offers us the ability to understand and apply what we are learning in the classrooms. It also teaches us patient care. Most of all, it allows us first-hand interaction with our patients, our biggest teachers. I have referred to clinic in many blogs, as it is personally my favorite part of the program. Of course we could not be in clinic without the classes teaching us AOM, but the clinical interaction is so meaningful to me. It's a chance to bring everything we learn and use it while having our patients teach us how it affects them. 

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While in clinic, students are very focused on the care of their patients. This offers the opportunity to do extra research on a case-by-case situation. This is a very valid method for us to expand our understanding of specific conventional medicine and AOM diagnosis and treatment plans. We have rooms where we are able to work on our research and charts, allowing a thorough understanding of our patient and their care. 

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We have a clinician room that we use for every patient. Hui Yan Cai, PhD, MD (China) is pictured in it in this blog.

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Dr. Cai

When a patient arrives, the intern enters the room and performs an intake. From that information and previous research for ongoing patients, the intern meets with the clinician in the clinician's office. Then, the clinician also performs a short intake on the patient. Through this interaction, the intern and clinician formulate a treatment plan.

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Once the clinician has seen the patient, the intern is able to begin the treatment. Just as the intake portion builds on the intern's knowledge base, much learning occurs during the treatment aspect of the appointment. This portion allows the intern first-hand experience to comprehend the impact and reaction of the intern's application of AOM. 

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In this week's pictures, several observers and interns are shown working on clinical work. In clinic there are observers who observe every aspect of clinic. They also play a crucial role in keeping the area clean during the clinic shift. Once a student moves from observer to intern, they begin treating patients.

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I feel NUHS' clinical setting is one of our greatest learning opportunities. I think most of the students feel this way, as well.

Shoulder Trauma Treatment

A patient I've been treating for a shoulder injury agreed to allow me to share her acupuncture experiences.

About six months ago, the patient experienced a work injury causing a shoulder trauma.  The final result was an internal tear and bursitis. She received conventional medical care and AOM treatments of acupuncture and herbs. She felt the AOM treatments decreased the pain and increased her range of motion temporarily.

Eventually, the patient decided to have surgery, as everyone thought it was in her best interest. Three weeks after her surgery, she had another shoulder tear, but in a different location. Surgery was not an option and her MD recommended she receive AOM treatments again to aid in healing, range of motion and decrease the pain.

The patient has been receiving these acupuncture treatments on a non-routine basis for her shoulder injury here at NUHS for over 6 months and reports positive results. She lives out-of-state, so she only receives treatments when she is able to travel to Illinois, per her choice. She says she feels most comfortable receiving acupuncture treatments at the NUHS clinic and is not interested in going elsewhere for her AOM care.

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I have included a picture of an NUHS clinic room to help make
this patient's experience more vivid for you as you read.

In the pictures, some of the acupuncture points are shown. Two very important points are her local shoulder points, jian qian and LI15. These points have been painful for the patient. Each time they are needled, the patient has a different tolerance level for them, and for the depth she can handle them being placed. She also has a range in her tolerance of the ability to handle them being manipulated.

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Manipulated means moving the needles around to help stimulate qi and blood flow. This helps create an immune response to aid in the healing process. These points are partnered with several other distal points, points further away from her shoulder. Only a couple distal points are pictured. All this points work as a union to create a healing effect. An example of a distal point is liver 3, the point needle on her foot. This point helps move the qi and works very well when partnered with other points in her treatment plan.

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In addition to her acupuncture treatments, she has been recommended to take an herbal formula that is pictured. This formula, Jian zhou tong pian, is specific for treating bodily trauma. It helps the tissue repair itself.

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So far, the treatments have been reported as successful by the patient. She has reported a decrease in her pain level. She reports this pain relief lasts well after the end of the treatments. Since she has recently restarted her AOM treatment plan, her range of motion has not been reevaluated. I have a positive prognosis for her since she is having instant results shown by her rapid decrease in pain level.