Halloween!

Oh boy! Halloween flew by fast! But it was fun-filled for the kids! We started things off the weekend before when Old Navy had a big Halloween special. Any kid who dressed up get a coupon for a free screen print t-shirt. Plus, there were tons of discounts throughout the store that day! Braylei had her beautiful Cinderella outfit that Meghan's mom made, and Tayscen was supposed to be a lion, but didn't wan any part of the headpiece. So we knew we'd have to make some adjustments for Halloween. Luckily, Old Navy had all their costumes on sale for $5 during those few hours, and there was a pretty cool Ninja outfit that would be good for him and for general dress-up play around the house!

On Halloween, I dressed as festive as I could to work. I had recently begun my Psychiatry rotation which is at Rosewood Ranch Center for Eating Disorders in Wickenburg. It's all inpatient, but it's pretty laid back. I wore my bright orange dress shirt with black pants. I also had on my black skeleton shirt I bought at Old Navy for $1 underneath my dress shirt, but it was buttoned down enough to see the ribs pretty good! I found this somewhat humerus, so I posted on Facebook whether or not it was bad to dress up like a skeleton to an eating disorder facility! It went over great, though! Some of the patients went all out for their costumes, based of course on what they had. The girls mainly dressed as crazy psychos, or Hollywood divas at an addiction center. Cool stuff like that!

I got to leave a little early so that I could get back for the kids. Each year, Midwestern puts on a Safe Halloween Carnival event. The kids trick or treated at all the department offices throughout the school, and then there were cool games and activities in the Cafeteria, like fishing, cake walks, cookie decorating, and ring toss stuff. Then outside there was a bouncy castle and a couple of other games. Then we headed back home where we had a potluck with our neighbors. We got to hang out outside and let the kids run around. Then all the kids went together around trick or treating in the subdivision. Braylei loved it, but Tayscen just wanted to run around.

A cool new tradition we implemented for the family is the Great Pumpkin! Since the kids don't need all that candy for Halloween, we thought it would be a good idea to trade it out for something cool. We did it with Braylei this year. She got to pick out 5 pieces of candy she wanted to keep, which she could have periodically, and the rest she left out for the Great Pumpkin. In return, the Great Pumpkin leaves a toy or other surprise. This year, the Great Pumpkin left a Cinderella Barbie with a horse, along with a Halloween Strawberry Shortcake DVD!


Braylei's preschool class (she's a year younger, why she's so short); Braylei getting a pumpkin at the farm; Braylei decorating her pumpkin


Braylei as Cinderella; Tayscen's intimidating Ninja custome with his Chuck Taylor's; bro and sis


At Midwestern: Bray eating the cookie she decorated; Taysce in stealth mode; fishing with the kids; Me and Tayscen

Braylei on the Bouncy Castle


The kids from the hood; trick-or-treating; Braylei hitting the Halloween pinata!


Taysce getting the pinata; children looting the streets (is Taysce doing the chicken dance?)

OMM Research

I always caveat my passion for OMT by stating that it is a great tool and provide a great use, but that it's not like it will cure cancer or anything. True, it is awesome for musculoskeletal pain, headaches, migraines, pregnancy uncomfortabilities, and even some GI or autonomic problems. Well, I recently had the opportunity to perhaps build on that foundation when I teamed up with Midwestern's OMM department for their Parkinson's research study. I was asked to be one of the clinicians for the study, where I would either perform an experimental treatment or a sham patient, assigned randomly to study participants over a 6 week period. The aim of this study was to see if the use of OMT, specifically Muscle Energy/PNF, could reduce physical symptoms felt from Parkinson's Disease. Muscle Energy uses proprioceptive neuromuscular facilitation that targets the golgi tendon organs and muscle spindles and manipulates their normal responses in order to increase flexibility, decrease pain, and increase overall functionality to a given muscle group.

This turned out to be a very cool study indeed! It was awesome interacting with these Parkinson's patients! It was randomly assigned whether of not the would receive real or sham treatments, but those who were sham patients would be given 6 real treatments upon completion of the trial. It was still hard performing the sham treatment to the same person week after week, especially when the would come in and tell me that they felt like they were improving. What can I say? I'm just a darn good sham clinician! The post-trial assessments were just done on Friday, so I am excited to see how the results are! Hopefully good enough to be published, as that does look very good for residency!

Rotation Block 4: Sports Medicine/Orthopedic Surgery

This last rotation was spent with Dr. Gary Waslewski, MD at the Arizona Sports Medicine Center. Dr. Waslewski serves as the orthopedic surgeon for the Phoenix Coyotes and also works with the Chicago Cubs and San Francisco Giants, whose rehab programs are stationed in Arizona. He also is the team physician for Chaparral High School, which was a nemesis of my high school, Tempe High. Having a true interest in sports medicine, I wanted to see both aspects of the field- the primary care side and the orthopedic surgery side. Although I had strong leanings already for the primary care route, I wanted to see firsthand what life as an ortho doc would be like. To start with, Dr. Waslewski is easily the nicest and must humble surgeon I've ever met. His patients love him because he is actually willing to listen to them. After examining a patient, he'll usually say something like, "Hmm. So what are we going to do about this?", before going into a number of different options for the patient to decide upon. This was very gratifying to the patients, as they were able to weigh the pros and cons of each option. Then, another cool aspect was that they didn't feel like they had to decide right then, as he would tell them that he would write up the note, and then when his medical assistant goes through them the following day or two, see would call the patients to schedule either a surgical procedure or conservative followup. He also reassured the patients by offering a number of conservative approaches, instead of pushing them into surgery right away. Of interest, he was very interested in Osteopathic Medicine as a valuable alternative approach. During my first week working with him, we saw a mid 30s lady with chronic Right hip pain. Imaging showed some arthritic changes, but not really enough to mandate surgical intervention. Injections had proved unsuccessful. Out of the blue, he said, "How's you hip and pelvis OMT skills?" I said they were pretty good, and began a quick eval. Her seated flexion test was prominently positive on the right side, revealing a locked out SI joint on the right side. I made sure to show Dr. Waz the huge difference there as she bent forward for the test. I also quickly evaluated her innominates by rocking her ilia anterior to posterior, which showed major restriction on the right side, as it was stuck anteriorly. At this point, I had Dr. Waz come over and rock her ilia and put my hands over his to ensure that he could appreciate the difference. So I did a few techniques to balance things out, explaining to the patient, Dr. Waz, and his medical assistant, all of whom seemed mesmerized, what my treatments were accomplishing. When the patient got up from the table, she stated she hardly felt any pain! It was such a thrill! Sharing my enthusiasm for osteopathic medicine to the medical community is almost the same rush as sharing my testimony of the gospel of Jesus Christ (although of course not as eternally fulfilling)! I got major props from Dr. Waz and his assistant, which opened up a lot of opportunities for me to incorporate OMT into this allopathic rotation!

I also had the chance to follow and work with some of the other docs in the practice, which is always nice to see how each physician conducts his/her practice differently. One doctor, Erik Dean, is a primary care physician who specializes in sports medicine. I was able to spend a week with him, which was completely awesome! I really enjoyed the diagnostician role of the primary care sports doc, which was more acutely injured patients. To me, it is more exciting seeing a presentation and trying to figure out the injury based on history, mechanism of injury, and clinical exam, than to have all the imaging and saying what it is and decide the plan of care. I also was able to do a lot more procedures with Dr. Dean, as the primary care schedule is more spread out than the clinic time for a surgeon. Overall, it was a great rotation!

Braylei's 3rd Birthday!

I am quite belated in my posting of this, but on September 16, Braylei turned 3! It's crazy how fast the time goes! We had her birthday at the Peoria Splashpark! We didn't think that it would be very crowded, but it was packed! Luckily, we found a ramada to set up! The kid's played in the water for awhile, and then came back over to have some cake and hit the pinata! For cake, we actually had cupcakes, but they were iced over and was the Little Mermaid! Braylei loved it! We also had a Little Mermaid pinata. Braylei had a blast and she had a lot of her friends come! I mainly wanted to post all the pictures from the festivities!

Rotation Block 3: FM/OMM

This last rotation was spent with Dr. Markham McHenry, who is dual board certified in Family Medicine and Neuromusculoskeletal Medicine. He owns his own private practice in Scottsdale and is also part of the OMM department faculty at Midwestern. This was really a spectacular rotation. It was really neat to see how a private practice is run, and I learned about what all goes into it. My biggest reason for seeking out Dr. McHenry for this rotation was to learn how to integrate true OMT into a Family Medicine setting. I was relatively comfortable with providing a designated OMT visit, if given 1/2 hour- 1 hour, as they are scheduled at our University clinic, but he does it in 20 minutes, comparable the military visit timeframe. The first time I saw a treatment, he blew me away! He truly incorporates the philosophy that the body is a continuous unit and that a problem at one end of the body can have big impacts on other areas of the body! He also integrated a lot of teachings of Dr. Philip Greenman, a master of exercise prescription. This mainly focuses on muscle imbalances, firing patterns, and retraining techniques. He was very good at not only treating a patient's dysfunctions, but also giving them exercises or stretches to help retrain the body to prevent recurrences. In addition to the musculoskeletal cases, he saw a wide range of family medicine visits. I really enjoyed the balance there. I was given pretty loose reigns while there. I would see many of the patients first, get the H&P, come up with an assessment and plan, and then present it to Dr. McHenry. He would then go back in with me and finish the visit. With the OMT visits, I would start the treatments, and then Dr. McHenry would come in at some point and finish up. It was really encourage that most of the time, he would tell me that I had corrected nearly everything, and that he just needed to spend a couple minutes with the patient so they felt that he was spending the time with him. I was pleased that numerous patients complimented my skills and commented kindly to Dr. McHenry regarding my treatments. One long-time patient told him that I was easily the best student that had treated him! I also gave many flu shots and saw a couple joint injections. I came out of this rotation a lot more equipped in not only my OMT skills, but my entire medical knowledge was bolstered this month!

Rotation Block 2: Army Family Medicine

Throughout August, I was on active duty with the Army, stationed at Fort Carson, near Colorado Springs, while I completed a 4 week medical rotation in Family Medicine. It absolutely rocked! Going into my third year, I was already heavily leaning toward family medicine, but this was nearly the clincher this month after having any doubts about what family medicine would be like in the Army laid to rest. From day 1 I felt welcome and a part of the Army healthcare team, and by the end, I knew this was where I am supposed to be! I totally love the broad scope of practice covered in family medicine within the Army. They really give you reign to become credentialed in whatever you want, whether it be more OB- even cesarean section deliveries, more GI procedures like colonoscopies, flex sigs, even appendectomies! You name it, you can do it! The way they accomplish this is via a number of unopposed family medicine residencies within the Army. An unopposed residency is a residency program located at an Army community hospital (MEDDAC) that only has FM residents in addition to the clinical staff. Therefore, the FM residents do much more inpatient service, work more closely alongside the surgery, OB, and peds staff, and getting far more procedural training than a residency that has to compete with IM, OB, surgery, and peds.

The other aspect I was curious about was in regards to how much I would be able to incorporate my osteopathic medicine training. I knew that some residency programs have already started up osteopathic specialty clinics that the D.O. residents get to do about once a week, but I want to integrate OMT into my everyday practice as well. Well I was fortunate enough to have a D.O. preceptor, CPT Joshua Will. He is awesome! He served as a great mentor, as he is much younger than my wise and well experienced cardiology preceptor, Dr. Cucher is. It was really nice to have a preceptor that I could relate with on many levels. He also used a lot of OMT in his practice, and recounted many stories about how sought after OMT is in the Army, especially overseas on deployment. Soldiers will seek you out if they know you are a D.O. and utilize osteopathic manual therapy.

I was assigned to one of the four family medicine clinics on Ft. Carson. It was really cool to see how integrated the healthcare team is in the Army. Everything is on one system (AHLTA), and put through a prescription at the end of the visit, or order labs, and your patient can just walk right down the hall and do them. You can also see whether or not they get the script or orders filled right away, lab results come back super fast, as do imaging reports, too!

I was able to get a lot of practical experience while up there. I saw a ton of patients, a lot of school physicals, and some cool procedures, including two vasectomies and a cesarean section! To be able to assist on these was totally awesome! I learned so much and was given so much guidance from all the physicians there! It probably will be my best rotation of the year, and moreover, it will totally prepare me for my audition rotations coming up next year!



I was also lucky enough to have my family come up to see me for a week and a half! It was fun for the kids to get away, even if the normally 12 hour trip took Meghan 18 hours due to the increased amounts of stops for the kids! We had a great time, tough! Unfortunately, there was a lot of rain storms that hindered our plans to see some things. We wanted to take the kids to see Santa's Workshop at the North Pole (conveniently located on the north side of Colorado Springs), but they were closed the days we were to go due to the weather. We did, however, go to the Cheyenne Mountain Zoo, despite the rainy weather! It was the coolest zoo! It is built on the mountain, offering some amazing exhibit enclosures and really unique terrain! We were able to feed giraffes, Braylei touched a snake, we were up close to wild deer (part of the mountain, not the zoo), and saw everything from Hippos to Grizzly Bears! We had a really great time! During the week, the kids also got to ride horses at some family friends. One weekend, I was showing them around the post and we were playing at one of the big playgrounds. Then all of the sudden these sirens started going off! We thought it was an air raid at first. But it was a sever lightening warning issued. We thought we would have a few minutes, as the dark clouds seemed a little ways off, and let the kids keep playing. Then out of nowhere it started pouring! We hurried and got the kids under cover under some playground equipment, but we were still getting wet as the rain started coming down sideways and then leaking from above! We decided that we would be there awhile if we tried to wait it out so we made a break for it. Most unfortunately, we were a good 400 yards from the car, so we were all soaked, and got all muddy from sprinting through the park. It made for a great memory though! Another cool thing we did was go a dinosaur museum in Canon City! There were cool exhibits, including the most complete Stegosaurus fossil in the world, fossils the kids could touch and sit on, and a really cool children's discovery area, where they could find pretned fossils, play with dinosaur toys, compare dinosaur fossils to other bones, and color. I probably had as much fun as the kids did!!




And lastly, after getting back home, Braylei got her hair cut short, which is what she wanted. It looks so cute and she looks so grown up, with the exception that she is so small!

Schroeder Family Update

I haven't been doing a very good job of keeping everyone updated with our summer adventures, so I'll try to do a quick summary. 

Tayscen had his first birthday in June, and we had a fun little party for him with family and some of our neighbors! We went swimming in the community pool, and had a dinner/cake back at the house! We had a lot of fun! Meghan made organic low-fat chocolate cupcake and we iced the tops to make them look like baseballs! Believe it or not, those cupcakes were awesome! 

On another day following my board exams, we took the kids, plus our nephew, Kameron, niece, Kelsey, and little brother, Jon to BounceU, a huge bouncing facility filled with inflatable equipment from giant slides, obstacle courses, castles and other fun things! It was a blast! And a good workout! It definitely made my foot sore, as I was still rehabbing from my surgery at the time, but it was worth it!

Throughout the summer, both Braylei and Tayscen were in swim lessons run by the city of Surprise. We took them 4 days a week in 30 minute classes until the beginning of August. Braylei was in the preschool class, and she learned so much! It was really nice to see her grow more and more comfortable with the water. Most of it was water exploration, playing games in the zero depth area, being able to reach for things underwater, and work on basic swim stroke elements. Tayscen was in the parent-tot class. Meghan took him most of the time, at least through June, as I still had my stitches in my foot and couldn't get them wet. But I did take him alot in July, although it showed the he preferred his mommy over me.

We won 4 free ticket to the City of Surprise 4th of July Bash. There were tons of things to do there. There were bouncy castles, baseball pitch/football toss, and for the kids, Home Depot had a design a tile where she used an assortment of markers on the tile. She really like it! She also got her face painted. The downside of the night was that it got really stormy and windy. There was a big dust storm and the fireworks show was delayed for like 2 1/2 hours! But the kids really wanted to see the fireworks, so they got to stay up really late and they ended up having the fireworks after all!

 

We also ventured a couple times to the Peoria Splashpark. It is a really cool place for the kids to have fun! We went with some neighbors and had a blast! Tayscen was having fun walking around and Braylei was splashing through all the sprinklers and fountains!