Merry Christmas

I have survived the return to med school following Thanksgiving break, and although the stretch of tests were not fun, I manage to scrape decent marks. The tests were all pretty fair and straightforward, so I can't really complain about them. The quirky schedule, having our last test on Monday, yet having class through Thursday, was not conducive to my, nor most of my classmates' learning. All of our motivation left after the Pharm test Monday and for all intents and purposes, break started then. Even the professors partially checked out by then too! Oh, well, I'll have plenty of study time over the break after Christmas. Since last post, I have also had a few OSCE's (simulated patient experiences). My last interactive session (in teams of three) was Thursday afternoon. We had a sore throat module, which through differential diagnosis we determined to be strep, a bacterial vaginosis case, which was altogether confusing and weird, especially since our facilitator/patient was a male. It was quite the surprise to me as I was gaining a history to say the least! But we had a pelvic model to run the pelvic exam, but it was still weird! Then my third case was a low back pain, which as osteopathic medical students, we destroyed. There are actually a lot of differentials with low back pain. We have to rule out cancer, kidneys, visceral problems that would refer pain to the low back, or vertebral injuries such as compression fractures, spondylolysis (Scotty dog fractures), spinal stenosis, osteoporosis and so forth. Then of course there's back pain that is musculoskeletal in nature. Now most physicians would just diagnose this as nonspecific low back pain or mechanical back pain, but using my osteopathic training and anatomical knowledge, we can find the muscles or muscle groups that are affected. For example, if the patient says that they feel better bending forward or lying in the fetal position, it is likely the pain is stemming from a psoas/hip flexor problem that is pulling the upper torso forward. If however, they are backbending to find relief, the spasm/injury is from the erector spinae/paravertebral muscle group. And, in addition to prescribing muscle relaxants or pain killers, we can treat the patient right there with soft tissue work, then follow up with manipulation of the vertebrae if there are somatic dysfunctions that are facilitating the pain. We can also refer to physical therapy the strengthen the core abdominals to relieve the load on the low back! So there's a lot to think about with each patient you see in coming up with a differential diagnosis. It takes a lot of time to get this down, which is why we spend our entire 3rd and 4th years in clinical rotations with patient interaction to practice this over and over again! Speaking of, we also have to plan our 3rd year rotations, so I've been trying to get information about it. We have a number of core rotations we have to do such as family medicine, internal medicine, pediatrics, OB/GYN, general surgery, rural medicine, etc. Midwestern has a lottery set up where we look at student reviews and can pick the top three places where we want to rotate, and the computer will sort it all out. The tricky part comes when you are trying to schedule military rotations or an away rural rotation. For instance, I am trying to set up my rural rotation in Cedar City, Utah, where I did my undergrad, but I have to set it up myself, find which month I want to go, and make sure the computer blocks that time out so I don't get scheduled for another rotation at the time. And the same is with my military rotations. I can do an early experience Army rotation, which is tailored for young students who haven't had a lot of experience to do at the beginning of the 3rd year, to get used to military hospitals and their system. I'm looking to do mine in August at Ft. Carson, which is near Colorado Springs! It should be a lot of fun. And Meghan and the kids can come for a good portion of it, as Meghan's mom's best friend lives right by there and they can stay with her. So I am very excited to start my clinical experience, albeit a little nervous.

More importantly, Christmas is looming so near! As Braylei is 2 now, and knows what's going on, we really want to emphasize the spiritual aspect of Christmas and why we celebrate it. So one family home evening, we each wrote down what we wanted to give to Jesus this year. Braylei decided that she wanted to give Jesus a birthday cake and work on sharing with others! It was so cute. She drew Jesus a picture, then we put all the little papers in a small box and put it under the tree. On Christmas morning, we will open that little box first and read them all in order to keep an emphasis on the Savior. We have also been reading Christmas related scriptures each night and sing Christmas songs. Braylei has learned Jingle Bells pretty well, too. This past week for family home evening Braylei made a little gingerbread house with graham crackers and icing. I think she ate more of the candy decorations than actually got on there, but she had a lot of fun, and there was a lot of mess to clean up, too! Another thing we did this week was take names off of the giving tree at Walmart and Braylei helped pick out toys for underprivileged children that otherwise wouldn't have anything for Christmas. As Braylei gets older (and Tayscen too), we will give them more responsibility and ownership into an act of Christmas service.

On Saturday, my mom, sister Suzi, along with her husband John and daughter Elizabeth, came out to the house to spend some time with us! It was good to see them. Braylei had a really good time playing with Elizabeth. She loves the Little Tykes drawing table that her grandparents got for her, too! Then today, for Christmas Eve, Meghan's parents, along with her little bro Jon cam out to the house to see us! We had a white elephant gift exchange and reenacted the nativity. Tonight we went to see the downtown Glendale lights, which were really nice. We came home and Braylei put out cookies and milk for Santa and a special magic key for Santa to be able to get into our house since we don't have a chimney! I'm sure excited for Christmas tomorrow and I'll post again soon with pictures and video of our Christmas!

Going, Going, Back, Back, To Med School, Med School

Oh, how sweet my short-lived break was. But alas, I have been back in school for two weeks, and I feel as though I won't get back in the swing of school until we get another break for Christmas in a week and a half! It's not easy to jump right in and study like that after enjoying a nice break. And I even studied a little bit during the break for my board exam coming in June! It's nuts!

But classes are good, nevertheless. Everything seems to continue to grow more and more clinical. We are in the midst of scheduling our clinical rotations for next year, which is insanely confusing, as they only talked to us for about 10 minutes regarding the process, thus making our lives even more frustrating and stressful than they already are thanks to Pathology, Pharmacology, and Microbiology! We have 3 tests over the next week. Tomorrow we have a Pathology test on the GI system. I love that my professor prefaced this with being a super short test, covering only 14 hours of lecture. However, the amount of material this test covers is extensive, and our objectives packets are longer than in the past, irrespective of how much she covered in lecture time! Oh, well, I guess we'll have to see how this one turns out. Then we'll turn around and have a Micro test on Friday and a Pharm test on the following Monday. Hopefully I'll do better on that one than I did on my final!

After the Pharm test on the 17th, we still have classes through the 20th, but no tests until after the new year. So a bunch of us are going to go see the new movie "I Am Legend" with Will Smith Monday afternoon at the IMAX by our school! Then on our last day, Thursday the 20th, I have my last interactive OSCE (simulated clinical experiences). Those have been very helpful for me with my clinical skills! We are paired up in 3's and we see a simulated patient who has a group of symptoms. We share responsibilities in that one student performs a detailed history and asks the questions, then another student performs a focused physical exam according to the information gathered in the history, and then from that the third student gives a patient presentation with an assessment, differential diagnosis, and plan of action. since we have 3 of these, we rotate responsibilties each time. After break, we will have 2 individual OSCE's where we are by ourselves and do the whole exam before receiving feedback from a physician facilatator. Yikes! It should actually be really fun. I'm looking forward to it! The clinical aspect of medicine is what really excites me. My Osteopathic Medicine class has also been more clinically focused. We went through a low back pain module and walked through different clincial scenarios and how we can treat those problems. That's what I love about osteopathic medicine. When someone comes in with neuromusculoskeletal pain, we can actually treat the pain and the underlying problem and not just mask it with medications. But we can always augment our treatments with pain relievers or muscle relaxants! It's awesome!

But, going back to the break, it went way too fast! We had a really nice Thanksgiving, though. In the morning, I went and played in our ward's turkey bowl, which didn't have a good turnout at first, but people slowly showed up, including the Elder's, and we had a fun game! Later in the day I took Braylei swimming, as the pool is heated (and we live in Arizona and it hasn't been that cold, anyways). Then we had our families over to our house for dinner. It was really nice not having to take the kids out and about, especially with both families close by. It's so hard to take them out all day and into the evening when they go to bed. It throws everyone's schedule off and then it's harder to get back into. Then of course came Black Friday. This has been a longstanding tradition with Meghan's family. Thanksgiving evening we go through all the ads, decide what everyone wants to try to get, and then we split up to the various stores. I went to Best Buy to try to get a computer for Meghan's parents. I got there around 2:30 am, thinking that would be enough time to get a good spot. Oh, how I was wrong! When I arrived, an incredible line was already formed past the outside of the store plus 2 adjacent stores! Apparently, people had been waiting in line since about 7pm the previous night! How insane is that!? At least they handed out tickets for the various door buster items around 3:30am so by 4am I knew for sure that I was out of luck so I could go home. Meanwhile, Meghan and her dad were out at Toys R Us really early too, and had slightly better luck than I did, but not much!

And finally, we enjoyed the opportunity before I headed back to school to put up the Christmas tree and holiday decorations! Braylei was a big help and had a lot of fun. I invite all to see some of the video clips that are on the YouTube bar at the top right of the blog! Or you can see all the videos post on YouTube at http://youtube.com/thejschro. We have tons of decorations for the inside of our house, most of them Meghan has made herself! But we are lacking in the outside ornations. I think we will wait until after Christmas and buy stuff while it's 90% off and save it for next year!

The kids are doing well. Braylei continues to grow and astonish us all with her development. Last week, Meghan had some of her file folder matching games she had made for when she taught preschool, which are 3-5 year old level, and let Braylei play with them and Braylei did them all! I can tell she has so much of Meghan in her! Meghan is the master of memory games and stuff like that and Braylei is definitely following in pursuit. Tayscen continues to be just a happy-go-lucky kid. He loves his jumperoo so much! And he just got in his first tooth! We saw the ridges of it yesterday!

On a sadder note, my uncle, Ron Hottman, passed away recently from small cell carcinoma of the lungs. He was able to spend his last days at home. Our thoughts and prayers are with my aunt Janet (my dad's sister) during this very difficult time. Also, Meghan's uncle, Jay, recently suffered an abdominal aortic aneurysm. Luckily, doctor were able to find it before it ruptured. He has since, however, had many complications from the various procedures and treatments and our prayers are with him as well, hoping that he will recover soon!