S2W8: Onward & Upward!

Spring is here - we survived the winter! 

(It probably wasn't as bad as we made it out to be).

Having said that, I did start the week with another cold! More phlegm to expel and a headache. I admit that I did skip a few lectures in an attempt to recover in time for Thursday's placement. I did however attend my labs and tried to uphold the highest of hygiene standards with the help of some cold medication..... drugs!!!

Not that my intentions are to advertise any drugs through this blog!

I'm on my third and final placement for the year, again at the Dunedin Public Hospital. However, I'm a few floors up from the outpatients physiotherapy clinic (eight floors up to be exact)! It's nice to be finishing on top (there are only eight floors to the Dunedin Public Hospital) with a mixed bag of patients including elderly who have fallen, patients with chest infections, strokes, other neurological conditions and oncology patients. I think the hospital placement is going to be my favourite. Physio is a team sport, there is an amazing interaction between physios and other staff - I simply could not describe how awesome it is. Bring on next week!

Quote of the week: Physio: "Are we your favourite people in the hospital now?" [Patient smiles but withholds a reply]... Physio continues, "We're all seeking your attention, so just tell all the staff that they're your favourite."  - there seems to be a bit of rivalry (healthy competition) between the nurses, occupational therapists and physios to be the best health team.

Physio sign I saw on the way up to 8th floor

Halothane, Enflurane, Isoflurane, Desflurane, Sevoflurane... Diazepam, Lormetazepam, Nitrazepam, lorazepam, clonazepam, flumazepam, tremazepam, triazolam, midazolam, chlordiazepoxide... You get the idea, there are a lot of drug variations with common suffixes! Thankfully so, as this helps us to distinguish which family or class of drug they belong to. Lecture one for pharm this week covered anxiety (anxiolytic action), sleep deprivation (hypnotic action) and general anaesthetics (sedative action)... with comprehensive insight to the mechanism of action involved. We also briefly discussed the Michael Jackson - propofol incident. The joke for the dental students in our lecture was to use the drug 'midazolam' for dental surgeries because it produces retrograde amnesia i.e. they won't remember the bad surgery experience!

Pharm on Friday 9am was also interesting as we discussed local anaesthetics, with the suffix -caine. Yes, like cocaine! But the biggest laugh was in relation to the deadline for our pharm assignment. Lecturer: "I know there have been a few emails from students confused about the deadline for the assignment - the lab manual says 1pm today, on online it says 5pm. I would like to clarify it here now, that the deadline is actually 9:30am." The class reaction was classic! Lots of panicked people! The lecturer: "bazinga" (quoting the tv series, Big Bang Theory - a phrase used on the show telling that you've been the subject of a great joke), "that's better than two cups of coffee!" (Yes, we were all awake now!!) I loved the joke. Well played/executed, great start to a Friday morning. I had submitted my assignment earlier in the week - so I got to enjoy this moment for all it was worth.

MSK labs continued with Mulligan and Maitland manual therapy concepts and techniques. This included manual therapy from grades one to four for mobilisations (we'll cover grade five, manipulations, next year) and mobilisation with movement (MWMs) techniques. MWMs had students + patients buckled together into a car seat belt.... well sort of - more like a lap belt from older vehicles from around 1990 with a buckle/clip joining a continuous loop/belt (obviously this technique is not done in a car).

MSK round two later in the week focused on whole knee and hip replacement rehabilitation. We learned the role of physios from pre-op through to post-op and discharge. These joint replacements sound easy to rehab, but there are many movements which are contraindicated, this requires the use of other techniques and a multidisciplinary approach - I for one,  think the occupational therapist sock aid is awesome!! (https://www.youtube.com/watch?v=zeVLLj-WLuA)

[Knowledge of movement diagrams may be a helpful prerequisite for understanding this paragraph]. One morning whilst taking a shower I ended up practising my manual handling skills (in an abstract sort of way) on the shower water lever. I decided the water temperature could be optimised by increasing the temperature. I knew the lever could be a little bit jumpy so I applied my manual skills. First I found resistance one (R1) by carefully applying pressure (note that resistance was felt at the beginning of the movement, therefore the lever hadn't yet moved - temp remained the same). I knew the water temperature I couldn't tolerate would be labelled P1 (pain 1). With this in mind I re-applied the most delicate pressure to the handle as to feel the point of resistance before the handle turned (R1). At this point I began a 4- mobilisation (the temperature increased ever so slightly, this was good!). I then got a bit impatient and tried a level 4 mobilisation (too hot, too hot!! - Quick turn of the handle back to square one - this must be what a manip feels like haha!). In the end (and after a few attempts) I had to settle for a Luke-warm shower. The distance between R1 and P1 must have been a 4-- or something. I do however recommend this as a great physio training exercise - no doubt I'll be trying this again in the shower tomorrow. I used my photoshop skills to draw out a diagram (below).

Medicing for Dunedin Tech is drawing to an end, we've lucked out of first place... next season boys!

The School of Physiotherapy is holding a fundraiser for the community physio pool (I done my aquatic physiotherapy training there earlier in the semester). It's a bit run down and the district health board were looking to close it. The physio students are giving massages for a small donation next Monday to help out / to show our concern - come and book in for a massage!

Luckily the weather over this first week of spring has been fantastic - long may it continue!