Archive for tag: clinic

Countdown to Graduation - 25 Days

Spring has officially come to Chicago, in the sense that we are now past March 20th. The weather may still seem very winter-like, but the giant gray colored piles of snow are consistently melting away day-by-day. And with the spring thaw, we have seen a significant increase in patients returning to the clinic. All businesses, whether a restaurant, retailor, or healthcare, were significantly affected by the unrelenting winter weather this year. But now, as winter washes away and spring sets in, people are returning to a more normal routine. 

As the patient volume has increased at clinic, several of the tenth trimester Chicago clinic interns have now finished with their numbers for graduation. The remaining tenth trimester interns should be finished with the rest of their numbers within the next two weeks. I can't believe that the end is so very near!

I began treating a patient this week with a chief complaint of chronic fatigue, pain, and weakness. The patient had been to several other physicians, none of which were able to help her with her symptoms. The patient did not know what else to try when a friend referred her to the NUHS Whole Health Center -- Chicago.

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After the initial history and physical exam, we came to the conclusion that the patient was suffering from fibromyalgia. Fibromyalgia is a chronic widespread pain and allodynia (heightened response to pain or pressure) syndrome. It is believed to be caused by a combination of physical, psychological, neurobiological, and environmental factors. Fibromyalgia symptoms can also begin after a traumatic or stressful event also known as post-traumatic stress disorder. Other symptoms patients might exhibit are insomnia, depression, anxiety, bowel and bladder abnormalities, and numbness/tingling sensation. Diagnosis is based on history of widespread pain for more than three months and tender points elicited on physical exam.

I have been treating the patient for about a week now, and her symptoms have decreased about 50% since the initial visit. I have been using a combination of chiropractic manipulative therapy, acupuncture, trigger point work, and supplementation to address her pain and fatigue. As the patient continues to progress, I will slowly add in light exercise, which will be designed to boost the patient's energy levels. One of the most interesting parts of this patient's history is when asked what the previous physicians did for treatment the response was a laundry list of pain medications, none of which delivered any relief from symptoms. And now after seeking out help from alternative medicine, she has seen a 50% decrease in symptomatology in the first week alone.

Internship Stress

Patient Population

Each clinic has a different patient population they treat depending on their area. At the National University of Health Sciences Whole Health Center - Chicago, our patient population consists of a mix of Polish, low income, and some students. A majority of our patients come to us from Community Health Center, which is a clinic that serves people without medical insurance. Once they are seen at that clinic, most of the treatment is 100% covered when they see us.

We do see some University of Illinois - Chicago (UIC) students, but not a large number. This is due to the fact that UIC offers their students excellent and affordable insurance through the university, which has almost 100% coverage when they see UIC MDs or DCs. We do offer the students 50% off at the NUHS Chicago Clinic for all services that we provide including: chiropractic, acupuncture, physical rehabilitation, and much more.

Internship Stress

Ever since the beginning of my education at NUHS, upper trimester students would constantly say, "Just wait until you are in your internship; it's so much easier." To those people who told me that, I have to say, "LIES!!!" Once you are in your chiropractic internship, you have a new kind of stress -- the stress of what is going to happen when you are finished.

For me, that stress has been decreased slightly due to the fact that I am finished with all my board exams (Part I, II, III, IV, and PT) and that I have job as an independent contractor lined up when I finish. But there is still so much to handle in order to get started as an independent contractor:

  • Your paperwork for your license along with a significant fee needs to be sent into the state.
  • After you receive your license from the state, you need to get an MPI number.
  • Then you need to apply to each health insurance provider you are planning to enrolling with.
  • And you need to buy malpractice insurance.

Photo of contract
The beginning of my contract as an independent contractor when I graduate.

On the business end of things:

  • You need to hire a lawyer and an accountant.
  • You need to get liability and disability insurance.
  • You need to file with the state as a limited liability corporation.
  • You need to start marketing your for your business.

Needless to say, it's a ton to think about, prep for, and the worst part is wait and wait for the state to approve the applications.

I think the reason I have found this process so stressful is because these are things I don't know anything about. I wear my health care hat very well, but I still need some time to figure out how to wear my business hat. Long to-do lists have become by best friend.

Olympics Post Mortem

To add to last week's blog... Watching the Olympics as chiropractic intern has been really interesting. In the past, while watching I was entertained and amazed at what the athletes could do. Now, I am both of those things, plus I am diagnosing and contemplating what athletes would need for treatment based on the sport they are competing in. I mentioned the moguls last week; the amount of ground reaction forces the athletes take to their knees and low back must be astronomical. As the athletes go through their runs, the commentators mention the multiple surgeries most of the seasoned athletes have had throughout their skiing career.

As a chiropractic physician, I would be an excellent addition to an athlete's training and medical team. By providing preventive care through a tailored treatment plan for the specific athlete, their abilities, and their sport, the athlete would most likely need fewer surgeries with less time taken away from training and competing. I do not think that chiropractic care would remove the need for some surgeries throughout their career simply based on the high amount of force their knees, low back, and posterior kinetic chain take.

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Talking to a student at the UIC health fair

Health Fair Benefits

On Thursday afternoon, I participated in a health fair on the University of Illinois (UIC) campus. There were several booths set up with information for students on nutrition, cholesterol screening, exercise, family planning, massage, and many others. At our booth, we had information for students on chiropractic medicine, acupuncture, and other therapies we provide at the National University of Health Sciences Whole Health Center - Chicago. It was a great opportunity for students and teachers to ask questions about what we have to offer and how we can help them. UIC students receive a 50% discount on all services at the Chicago clinic. Most of the students seemed very intrigued about acupuncture. What is it?  Does it hurt? What can it be used to treat? How does it work? Etc...

I had several interactions that might be very beneficial for the NUHS Chicago Whole Health Center. One of the professors at the UIC Nursing School had no idea that we were right in the UIC Marketplace. She has been to a chiropractor in the past for musculoskeletal issues and was very happy with results that she got with treatment. Now, knowing that our clinic is so close and affordable, she took several pamphlets for herself and to share with others at the UIC Nursing School. 

The other interesting conversation I had was with an employee of UIC Campus Care. UIC Campus Care is a self-funded insurance program for students, which offers comprehensive health insurance at a very reasonable cost. She mentioned that they are always looking for chiropractors and other doctors to add to their network. So hopefully at some point in the near future, the NUHS Whole Health Center - Chicago will be one of the preferred providers offering chiropractic care to more UIC students.

Three Weeks In

The ninth trimester interns have joined us at the NUHS Chicago Whole Health Center. The new interns do not have patients in the beginning of the trimester, so they help out with the tenth trimesters' patients and shadow us. It's a weird feeling knowing that you have people looking up to you. I remember when I started as an intern at this clinic back in September; I was slightly in awe of how much the tenth trimester interns knew and how smoothly they worked with patients. That all comes with time, and now there are new interns that might be feeling the same way.

In my acupuncture course this week, electroacupuncture, cupping, and fire cupping were covered. Electroacupuncture is a form of acupuncture in which a small electrical current is passed between pairs of needles. Electrical currents have stimulating effects, which can influence the cells, tissues and entire systems. It can be looked at as an amped up form of acupuncture and is particularly good for treating pain. I personally have used electroacupuncture on patients with muscle atrophy and certain pain syndromes.

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Cupping therapy before and after

Cupping or fire cupping therapy is an ancient form of alternative medicine in which a cup is placed on the skin to produce a local area of suction. The suction is created using mechanical devices or by using heat (fire). Cupping is considered safe, but it can cause areas of bruising and swelling following treatment. This therapy is used for respiratory conditions such as bronchitis, asthma, and congestion. It is also used for certain gastrointestinal disorders, muscular disorders, and certain types of pain.

The end is very near for me. I received a reminder email from Student Services to petition for graduation. They needed my size for my graduation gown, how I would like my name on my diploma, how many people I expect at the graduation ceremony, etc. This also begins the process of auditing all my classwork and credentials to ensure graduation eligibility. Very exciting!

Different Points of View

Over the past few weeks, our main clinician at the Chicago Whole Health Center has been out on leave. So during her time away, we have had a few clinicians rotate through. We all thought it was going to be a nightmare having different doctors rotating through, but it actually was a great experience. Each doctor brought a different point of view, different experiences, different techniques, and new ideas on what a practice should be. Each day we were taught things that the doctors felt were important to teach the interns at their own clinics. As interns, we also have a certain number of student chiropractic manipulations and observed chiropractic manipulations that must be performed in order to graduate. While doing these, the doctors that rotated through made it a point to show us new techniques to use on patients who are not responding to other adjustments that we are using.

Overall, it was not the nightmare that we thought it would be, but quite the opposite. We all learned so much and were exposed to things we might not have been had they not stepped in as the clinician. As an intern, it is important to be exposed to as much as you can be. Go out and shadow other doctors, ask questions, take seminars, etc., because when you are done, you are a doctor with all the responsibility that comes with that title. A special thank you to Dr. Cynthia Winston and Dr. Frank Frydrych, who spent most of the time with us, and taught us many valuable techniques. 

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Tri 10 interns hard at work in the Chicago clinic's conference room

On Sunday morning, I had another outreach event to attend with Dr. Rick Ezgur. The event was for the Chicago AIDS Ride, which will take place in July. The ride is a 200-mile bike ride from Evanston, Illinois, to Racine, Wisconsin, where the riders camp overnight. At the campsite, Dr. Ezgur and I will be treating riders for any injuries, aches or pains before they bike back to Evanston the following morning to the finish line. 

The event on Sunday was at one of the many cycling training sessions for the riders at the Lakeshore Athletic Club. The training session consisted of a two-hour cycling class, which was followed by an educational session. The session gave riders information on proper bike fit, nutrition, and stretching to avoid injuries during the AIDS ride. We have four more of these sessions in February, March and April to prep the riders.