The week really began on the Sunday night of the mid-semester break with our pre-tutorial pathology quiz. It's an online quiz with a 10min timer. It's open book, but you had better have super-hero Ctrl+F, 'find' on the page or in your text book, powers to be able to use this method for completing the test. You really need to know these off by heart. Anyway, I thought I had downloaded the lecture slides file, but I discovered (midway through my test) it was a broken file and I needed to re-download it. It was a race between my internet speed for downloading the lecture slide VERSUS timer on Blackboard's pops test. Internet timer 1: My flat internet speed 0. Lesson learnt, but I still got 9/10 in the test.
Pathology was all about blood. Our lab tutor was taking this lecture series so we knew we were in for a treat - she has a superb sense of humour! "Red blood cells are called erythrocytes... as you'll know, there is never a condition that has more than one word in pathology." And just like in tutorials, there were food analogies... here was this weeks shopping list: donuts (healthy RBCs), biscuits (resting platelet), splattered egg (activated platelet). To further emphasise the food theme, there was a powerpoint slide of a boy with a frog in his mouth and the anaemic symptom "pica" listed next to it, which describes unusual cravings (such as eating ice during pregnancy). Then, not to our surprise, the lecturer expanded on some different types of anaemia: microcytic hypochroic, macrocytic and normocytic normochromic anaemias. There were the usual coagulation pathways covered in slightly more detail than in last year's physiology or pharmacology with the associated pathologies. She warned us against banging our head against the wall or stomping our feet too much when we got stuck revising due to the destruction of RBCs (and associated haemolytic anaemia). With a different analogy she described G6PD deficiency to be like that of a perm in a hairdressing salon (Heinz bodies need G6PD to avoid getting stuck in the spleen - they look a bit messy, like hair after a perm). We discussed Vitamin K deficiency and it's effects on the blood, jokingly advocating chocolate and garlic as anti-coagulatives. In a different moment of brilliance she warned us against taking party pills off strangers as once having a case where a person was showing signs of acquired haemophilia without the usual pathology or history. It was a good week of pathology.
Along with megakaryocytes in our blood, the drive to have mega-expertise as physiotherapists is some other intrinsic factor that is flowing within our veins. This was evident in our careful and specific palpation of structures of the wrist and hand in MSK Initially we thought orthopaedic testing and treatment of the wrist and hand would be similar to the foot - in many ways, it was - but due to its importance, a whole specialisation for physiotherapists and occupational therapists has been created, "Hand Therapists". One cool thing hand therapists get to do is make individualised splints. In our lab, the closest we got to splint making was a taping technique to limit hyper-extension of single joints of the hand (this was still very cool). We covered a few tests of instability (e.g. Watsons test) and techniques to reposition carpal bones in the wrist (e.g. a manipulation of the capitate carpal bone).
Pathology was all about blood. Our lab tutor was taking this lecture series so we knew we were in for a treat - she has a superb sense of humour! "Red blood cells are called erythrocytes... as you'll know, there is never a condition that has more than one word in pathology." And just like in tutorials, there were food analogies... here was this weeks shopping list: donuts (healthy RBCs), biscuits (resting platelet), splattered egg (activated platelet). To further emphasise the food theme, there was a powerpoint slide of a boy with a frog in his mouth and the anaemic symptom "pica" listed next to it, which describes unusual cravings (such as eating ice during pregnancy). Then, not to our surprise, the lecturer expanded on some different types of anaemia: microcytic hypochroic, macrocytic and normocytic normochromic anaemias. There were the usual coagulation pathways covered in slightly more detail than in last year's physiology or pharmacology with the associated pathologies. She warned us against banging our head against the wall or stomping our feet too much when we got stuck revising due to the destruction of RBCs (and associated haemolytic anaemia). With a different analogy she described G6PD deficiency to be like that of a perm in a hairdressing salon (Heinz bodies need G6PD to avoid getting stuck in the spleen - they look a bit messy, like hair after a perm). We discussed Vitamin K deficiency and it's effects on the blood, jokingly advocating chocolate and garlic as anti-coagulatives. In a different moment of brilliance she warned us against taking party pills off strangers as once having a case where a person was showing signs of acquired haemophilia without the usual pathology or history. It was a good week of pathology.
Along with megakaryocytes in our blood, the drive to have mega-expertise as physiotherapists is some other intrinsic factor that is flowing within our veins. This was evident in our careful and specific palpation of structures of the wrist and hand in MSK Initially we thought orthopaedic testing and treatment of the wrist and hand would be similar to the foot - in many ways, it was - but due to its importance, a whole specialisation for physiotherapists and occupational therapists has been created, "Hand Therapists". One cool thing hand therapists get to do is make individualised splints. In our lab, the closest we got to splint making was a taping technique to limit hyper-extension of single joints of the hand (this was still very cool). We covered a few tests of instability (e.g. Watsons test) and techniques to reposition carpal bones in the wrist (e.g. a manipulation of the capitate carpal bone).
We're starting a new area of physiotherapy called 'electrotherapeutic agents'. This week began with a recap of the basics for hot/cold/contrast therapy. I'll tell you more after labs start next week! Hot/cold therapy seemed to be a weather systems intervention on the lower South Island this week. Dunedinites woke to a light covering of snow/ice on Tuesday which made getting to class early a bit hazardous and cold. There were some (myself included) that hadn't checked their email and ventured down to the cancelled 8am lecture. We surrendered to a warm beverage in the Hunter centre for general catch up and grumble about the weather. The weather had us questioning whether it was autumn or winter... the trees hadn't yet shed their autumn leaves so we concluded winter was still a few months away! We also had a good chat about Crossfit gyms. By the end of the week, the sunny weather with its glorious warmth had been revived and we were back to our enthusiastic selves in time to finish our first rotation of placement with a smile.
This was the last week of my Umove placement (neurological rehabilitation). It's now time to reflect on the placement and complete the necessary paperwork to pass PHTY355. Looking back, I feel that I have been able to put many neurological tests, outcome measures and interventions that we had discussed last year in to practice. The clients that attend Umove are great! Although they attend the clinic to improve their own health, they are very receptive to new students every three weeks even though this must become a bit frustrating. The clients look to us for crucial information about their condition and hope that improvements will come with physiotherapy. One of the tasks I had this week was to dip into the literature about homonymous hemianopia and whether a patient would be able to improve their vision enough to regain their drivers licence. The literature, as usual, was inconclusive but suggested that small improvements may be gained in the long term with intense training, however the error of measurement in these studies suggests that this 1-2degree improvement may be due to improved visual scanning during the task. My advice to the patient was to practice scanning to the affected side using eye and neck movements so that it becomes an automatic process, and to practice a visual task at home using their peripheral vision. The visual task was similar to the neuro screening test for homonymous hemianopia. The beauty of physiotherapy is that many of our screening tests can be adapted or used directly as training exercises.
We were off to Med Red lecture theatre (a School of Medicine lecture theatre with very comfortable red seats) for an interesting lecture about the history of physiotherapy in New Zealand and how the legal system here protects the citizens of New Zealand from any malpractice of professionals practising under our regulatory body. We were informed about the process for becoming a registered health professional and the importance of retaining a current annual practising certificate, auditing health professionals and the importance of professional practice. This is the second lecture where we've explored how professional and governing bodies can help us as physiotherapists (Physiotherapy New Zealand (PNZ); World Confederation for Physical Therapy (WCPT)) and protect the public (Physiotherapy Board of New Zealand).
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