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!