I struggled to get this week posted for a number of reasons.
I finally got to go back to naturopathic medical school for in-person practical sessions! This included a review of hands-on physical exams, gynecology examinations, manipulation practice, blood draws, and intramuscular injections. It was my first time seeing people in person at school in over 7 months! I was pretty overwhelmed with all of the stimulation but energized and excited at the same time. I did feel, however, that the timing of these practial sessions were poorly coordinated and coincided with a growing public health crisis in Toronto, Canada.
My schooling was abruptly discontinued after 6 continuous days of in-person practicals due to a rise in COVID-19 cases across the Ontario province. After a new lockdown, which contained even stricter guidelines than the previous year, I was feeling pretty deflated.
I quickly decided to jump on a plane and head to Texas. When I found out school would be paused for three weeks, I decided to take the opportunity to travel to Texas. This was no small last-minute feat! I had to drive to Buffalo, fly from there, and arrive with all of my documentation and ducks in a row. I decided to do this since my parents are fully vaccinated, and I hadn’t seen them in nearly a year and a half.
In any case, check this week’s learnings and tune in next week for additional preparations and precautions I took upon arriving in the USA!
Week starting April 12, 2021:
❓At the end of each visit, leave enough time to ask your patient, "Is there anything I haven't addressed that you would like me to answer?" This allows you to ensure you do not miss answering what might be bothering them. Sometimes the complaints and symptoms aren't the actual underlying fear.
💉I learned about an intravenous micronutrient therapy called the "Myer's cocktail." It contains a combination of magnesium chloride (2%), calcium gluconate, thiamine, vitamin B-6, vitamin B-12, calcium pantothenate, vitamin B-complex, vitamin C, and dilute hydrochloric acid. There are favorable reports on its use for people with asthma attacks, acute migraines, fatigue (including chronic fatigue syndrome), fibromyalgia, acute muscle spasm, upper respiratory tract infections, chronic sinusitis, and seasonal allergic rhinitis. I did find a 2020 report titled CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL; Intravenous Multivitamin Therapy Use in Hospital or Outpatient Settings: A Review of Clinical Effectiveness and Guidelines. This reported that no conclusion can be provided regarding IV multivitamin or micronutrient supplementation for patients with malabsorption issues, patients who underwent surgery, and patients with burns, trauma, intoxication, or serious infectious diseases in a hospital or outpatient setting. More research required.
💓I learned the difference between jugular venous distension and jugular venous pressure. I realized when I got into a physical exam scenario, I was inappropriately using the term interchangeably so I needed some remediation. Jugular venous distension is when the vein in the neck is bulging and is visible due to increased pressure on the right side of the heart- this can be a sign of a severe condition such as heart failure. Jugular venous pressure or jugular venous pulse is a visualization of the pulse in the internal jugular vein for waveforms that could be indicative of other heart and lung diseases. Understanding the different wave patterns allows a practitioner to consider potential issues when they observe them.
📓In naturopathic medical school, we are taught how to measure jugular venous distension, though an imperfect science, and are given the tools to learn how to read internal jugular pulse waveforms. It's fun to finally get into the nitty-gritty of physical exams!
🧬I learned about a term called scientific racism, also known as biological racism, which is a theory that that explains how racist bias has permeated historical and current research. I came to learn of this term in Dierdre Cooper Owen's book Medical Bondage, which explains the historical use of black women's bodies for medical experimentation. While I'm not completely done with this book, I am horrified to learn the truth of gynecology's roots in the United States. I highly recommend reading this book to anyone interested in understanding more about this topic.
🌹I learned how to perform a gynecological exam on a real human! I'm so excited to improve these skills and help provide a safe and comfortable environment for folks wanting to have this done with a naturopathic doctor!
🦴I learned how to perform manipulations of the skeleton! I had the amazing @dr.philipluu teaching me the tricks of the trade, and finallly started getting into the correct positioning and movements. I learned how to provide just the right amount of thrust to allow for the vibrational movement which can sometimes be heard as a crack! I’m excited to keep practicing this in the program, but can’t wait to find incredible chiropractors to partner with when I’m practicing. It’s all about those butter 🙌🏼!
🔥I learned in one of my coaching sessions with my incredible coach @erinjewellconsulting that I'm ready to start coaching again! I'm completely reworking my programs and content and will be excited to share it soon.
🩸I can stick and be stuck and not pass out! I actually made it through my first phlebotomy practical without completely losing it! Thanks to my amazing friend and test subject @christinaroper, I only panicked right when I realized I had actually gotten her vein on the first try! Luckily, the professor was talking me through regaining control of my faculties so I was able to safely complete the blood draw.
💉I have a severe needle phobia where I usually have a vasovagal response and pass out in these situations. So yesterday was a big accomplishment for me in my career! I’ve been actively working to overcome this phobia through our acupuncture classes over the past several years. While I have gotten better, and love giving acupuncture (mostly), I still struggle on the receiving end. I do think that yesterday was a testament to all of the work I have put in on this. I keep telling myself: I am not this body, and I don’t really care if it gets poked a little! Anyone else have any needle-phobia-overcoming tips?
🤕I had another manipulations practical and was reminded how naturopathic medicine can step in and really help people. @dr.philipluu preached that, "Reducing pain is easy. Changing behavior is hard." It really allowed me to step back and appreciate the naturopathic approach to patient care. We take such detailed intakes and dive into all aspects of our complex lives, and truly set the stage for conversations about behavior change. Not many practitioners do this, and I'm unaware of another profession who also takes this approach (in training) with repsect to marrying physical and psychological approaches to care. After all, if you crack/acupuncture/massage/stretch someone's back every time they come see you, but fail to remove the stress or repeated behaviors that are causing it, then the low back pain will never really go away...
🇨🇦I learned more about the Ontario government's response to COVID-19. We are now more locked down than ever. Parks were taken away. Borders were tightened- both the US and provincial. Policing was increased. The lockdown was extended another two weeks to make it six weeks total. We don't have a clear vaccination plan. ICUs are full and we are flying people out of Ontario for care.
🍁There is a federal response to paid sick leave, but it often falls short of being delivered on time to manage bills and isn't enough money to cover most familys' living expenses. Provinces then have a choice to also offer paid sick days to offset the time delay and/or make up the difference to meet basic standards of living. Ontario took away this benefit in 2018 under Doug Ford's leadership. If he were to admit now that reinstituting a paid sick leave policy is needed, he would have to admit wrongdoing in removing it in the first place.
✅What we know: Fix the situations where the outbreaks are happening and offer paid sick leave. Taking away public spaces and increasing policing is not the answer.
📷: Zar waiting for tonight's dinner: vegan Bolognese with equal parts cauliflower, mushrooms, and carrots to make the "meat"!
💉I learned how to give intramuscular injections! We practiced with B12, folic acid and saline. I'm still suffering from a severe reaction to being around needles I'm actively working to overcome. I immediately break out into a sweat, go white and really have to focus on breathing. I'm lucky I've been supported by amazing classmates who try to help me through those moments. An extra sexual thanks to @christinaroper for being my target practice!
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