Y3S2W2: Carpe Diem

Week two of MSK placement at Unipol Recreation Centre saw a gradual increase in clients. In between we practised our cervical up-thrust and down-thrust manipulations. We were also taught another manipulation technique for the Cx-Tx junction - I'm not sure what the technique name is. This technique is similar to a 'Full Nelson' in terms of the patient positioning (upright or sitting, with hands behind their head) but different in that it is more of a PA (posterior-anterior) manip than a distraction manip. We were taught two manual handing skills to achieve the same outcome (hands behind head or across their chest). Our clinical educator suggested we could try slamming doors (I'm sure we've all experienced a door that doesn't latch properly when closed) as a good way to get the feel of what a manip should be like - interesting analogy...

So the manipulation techniques we've learned in the BPhty degree so far are: the million dollar roll (lumbar manip), pistol grip manip (with various spinal loading techniques), screw manip (with emphasis on both PA and gaping the facet joint and including a unilateral costovertebral joint manip), the Cx-Tx manip (x2 manual handling set-ups, mentioned above) and the up-slope and down-slope manip for lower cervical spine. Now that's a whole lot of manip!! Just some more peripheral joint manips to learn and we'll be chiropractors (joking, of course!!)

In other Unipol placement news, I got to assess my first MSK patient. Somebody scheduled the client in for 8:30am, and I just happened to be half an hour early!! How's that for early bird gets the worm?! So this was MY first client at this placement to assess and treat from start to finish. The client had suspected ankle sprain (having cleared a broken bone out earlier in the week with a visit to ED). However, my subjective and objective findings indicated a stress injury of the distal 1/3 fibula. Interesting! My second patient on Friday was challenging because she was vague when providing the details that mattered - the onus was really on me to probe and control the conversation (and to be fair, I could have done a better job given the time available). I treated the patient's neck stiffness with a SNAG or two (or 10 to each side), and she could turn her head fully without stiffness - great!! I'll be seeing both patients again next week. I got to observe other clients with interesting presentations too. One patient that really sticks out [pun] had an acromioclavicular reattachment surgery - this patient had his AC reattached with part of a tendon from his hamstring. When the patient horizontally flexed his arm, we could see the clavicle ride up, to form a prominent step deformation, on his shoulder (... and this is after surgery, imagine what it would have looked like before surgery!!)

There was another opportunity for students to be involved in promoting the school, this time it was in semi-staged scenes to be recorded and edited into a television commercial. I volunteered and got to play the role of a student physiotherapist (I'm sure you were expecting that). The video crew aim to capture the culture and learning environments in which the physio students are in on a daily basis, such as practical skill labs, the School of Physio clinic, and at Dunedin Hospital. There were also a few short interviews with some second year students. I certainly had a good laugh playing my role which might be shown as snippets of a MSK physio consultation. The original plan was to assess a patient's ankle (it was legitimately in need of rehab) however during the mock-subjective the 'patient' flicked her hair (or something) and then we changed to assessing the cervical and thoracic spine. It was all a bit of fun, and because there was no sound recorded I could say almost whatever I wanted.... sort of. Anyway, we won't know what edits or which scenes actually make the final cut... but I'm sure many of the physio student's will have acting careers ahead of them should they choose the celebrity life. I'll attempt to add the advertisement to my blog when it is released.

Pedometer assignment... so last week I mentioned that we're recording our steps over the week with a pedometer. As you'd expect, there had to be an associated assignment - there was! This is a very small (and easy) lab report to be done in groups - the usual format: intro, method, results, discussion, conclusion, references. Here's a quick graph to show you how I got on. It looks as though there might be a trend, but I assure you there isn't - data can be very misleading.

During the cardiorespiratory lab, I thought I had beaten the system by blowing my spirometry readings off the chart (literally). What usually happens in a spirometry test (using old - manual machines) is the patient blows out as fast as they can for as long as they can, and the needle tracks the volume blown per minute. In my case, the piece of recording paper wasn't long enough (huge lung capacity, right? Unfortunately not). We decided the machine was probably at fault, so a digital spirometer was used. I recorded an above average result, but it wasn't super human or anything - I'm blaming fatigue after performing the test so many times.

Current assignments on the go:
-  EBP assignment.
-  Pedometer scientific report (groups)
-  Cardioresp patient goals / exercise programme
-  Cardioresp spirometry scientific report

Here's an interesting website about three strategies to trick your brain into coping with chronic pain: http://www.gradedmotorimagery.com/

The physio ball is coming up on August 15th and I've purchased a ticket! The theme is Grecian. I'm not sure whether that means we will dress with a single leaf covering our unmentionables, as Greek gods, in togas, like somebody from the movie 'Greece', as though our country is in a financial crisis, or to just go with a suit and tie.

Yes, that's right - it's Mrs Physio time again. I decided I would actually go to this event this year too to see what all the fuss is about. Here's a recap about Mrs Physio. It's a cross-dressing pageant, like Mrs Universe. Second years enter and compete across different sections: catwalk, interview, bikini model, and talent show. The student exec invite an honorary panel of lecturers to judge each section. Overall it's a pretty funny evening, well worth going to or entering (if you're brave enough). I've blurred the faces of the contestants and judges to preserve their dignities - can't have patients know that their future physio sung in a bikini or played the bagpipes whilst pretending to vacuum using their thighs. 

There are other groups that organise events within the student physio umbrella, such as the Physio Christian Group. I attended one of their activities prior to Mrs Physio... we went to a local business called 'Leap'. Basically it's trampoline heaven. 

 With a lot going on this week, we had to seize each day for all its worth!