S2W7: Life on the Pharm

Quote of the week: "There is no surgery that we cannot make worse" - orthopaedic surgeon taking us for a lecture on fractures. That quote would certainly make many patients feel uneasy going into surgery.  Also from the same lecturer, "orthopaedic surgeons have a 'rule of three', reduce, hold and rehab... any more would be too complicated". This was probably the most humorous lecture all week as he also shared/bragged (jokingly) about how fast he could perform surgeries "my personal best time for a hip replacement was 15 minutes, all before the bleeding starts - but then I have to reopen them...".

The week began on Sunday with an early morning isolation to study at the university computer lab suites... we're talking 7am here! The computer suites have 24/7 access via a scanner that reads a chip in your Student ID card (then you enter your access code). I had to catch up on a few lectures of pharmacology for there was a mid-semester test on Tuesday morning!! I closely associate pharm with big/long chemistry words like 'phenylethanolamine N-methyl transferase' and gibberish drug names like 'suxamethonium'... often we would rather suck meth on a mmmmm... just kidding!! Methamphetamine is really dangerous! Meth can act indirectly to release noradrenaline from neural vesicles, which then increases heart rate, BP, dilates pupils, inhibits gastric activity etc. Methamphetamine addicts can be identified by shining a bright light into their eyes (when their pupils don't constrict you may think 'Meth!?!'), also they are likely to be constipated (don't go monitoring your flatmates toileting habbits though! There are plenty of other, more observable-friendly, signs)

Our pharm mid-term exam covered aspects of pharmacokinetics, pharmacodyamics, antiplatelet & anticoagulants, cholinergic and adrenergics, anti-inflammatory drugs, analgesics & anesthetics, some drug interactions etc! Pharm is interesting and challenging - there are many pathways, receptors, sites of action and classifications to know. Lucky it was a multiple choice test!! When it comes to clinically treating patients, this course will be super helpful, but often I will be looking drugs up and suggesting patients to see their doctor or pharmacist.

There was a class photo on Tuesday too. This was organized by the physio student executive for the second and third year students. The class photo is to be purchased, so I don't think I will get a copy up on this blog.

I'm still medicing for Dunedin Tech, but the season is drawing to a close in a few weeks. We've had a good mix of wins and loses and are currently running for second place in the Otago premier league. Hopefully the team running to win will lose a few games so we can catch up on points (if we draw equal our team will win the league based on goals scored over the season). I'm medicing again this weekend and as the team is playing two games a week to finish the season on time, there are a lot of strapping and massages given to battered bodies before the games - one player broke his fibular (but unfortunately I wasn't medicing on that day!)

 

And so I had a birthday... I arrived in on Monday to the 8am lecture to be greeted with a birthday card! This was prepared last Thursday (I discover this having thought that I missed a class, because surely I would see this being done!) and I was completely oblivious! Well done to my peers for organising such a great surprise!

This was the last week of new material on the lower limb in anatomy. We learned about Tom, Dick and very naughty Harry... a.k.a Tibialis posterior, flexor digitorium longus, artery, vein, tibia nerve and hallucus longus! Did you know that some people do not have the muscle 'peroneus tertius' in their leg? Well, now you do! The next half of the semester will focus on the upper limbs.

We had another clinical placement debrief and heard stories from peers about patients with schizophrenia seeking treatment in a physiotherapy setting. This tied very well in with a lecture on ethics focusing on patient's rights. In New Zealand health practitioners must comply with the legal legislation "Code of health and disability consumers' rights" which is basically the 10 commandments of patients rights.

The semester finished with a pharmacology lecture on muscle relaxants covering spasmolytic and paralytic (neuromuscular) agents. We were informed about the toxin used on arrow heads by native American tribes and how we could load arrow heads and shoot patients with muscle spasm in our clinical practices. I'm joking, of course! Curare is however the plant substance that spasmolytic (spasm stopping) agents are derived from. Curare itself has been useful for hunting animals as it is an antagonist to ACh receptors at the neuromuscular junction (stops the muscle from firing). Hunters can eat the animal meat and not be affected because Curare is not bioavailable orally. Surgeons most commonly use paralytic agents to immobilise their 'pray-tents'... but make sure they administer an analgesic as well before operating! Oh, and the medical application of botox was covered too - it's not only used to make people's faces more "beautiful".

In more personal news, I have a flat sorted for 2015 and have been employed for 10 hours per week (on top of being a full time student). We are now on a one week mid-semester break. When we get back it will be spring (September)!

S2W6: Build Me Up Buttercup!

Last week I mentioned that I was going to take a warm-up for the diabetes classes with some class mates this week. Our clients were put through their paces with a little dance routine to the song 'Build me up buttercup" by The Foundations. Admittedly, the routine was a little bit difficult in terms of tempo and short regular changes to the next movements! I found it to be a bit difficult remembering the steps myself, even with two others calling out the moves as we went! It was a good laugh, and I hope the males in the group enjoyed this feminine warm-up... social norms shouldn't be left uncritically challenged - even if you do feel a bit embarrassed waving your arms around to a cheesy song! I led the cool down - that's something you can do with two left feet! The supervisor said it was the [quote] "best warm-up by a second year group that I have seen".

We've learned objective assessment strategies for joints below the lumbar vertebrae, finishing with the clinical biomechanics and assessment of the foot. Future MSK labs will involve case studies and applying our subjective and objective assessment skills to diagnose disorders and to clinically reason treatments for common musculoskeletal conditions.

The quirk of the week was a lighting problem in the Barnet lecture theatre for neuro. The lights would systematically turn off over a 30 second period. The lecturer had to continually increase the brightness or turn the lights on again between demonstrating physical assessments. The lab ended half an hour early due to the lighting inconvenience even though most of the class could have contributed to adequate lighting with their mobile phone flash-lights! If only we had brought candles!

"Hello Mrs Atrial Fibrillation, how is your husband Mr Diabetes-hypertension today?" Obviously this is not how we address patients. Unfortunately their condition often sticks more readily in our minds than their name. Here is this week's tip for surviving a community physio placement: how to remember patient names. Get to know them on a personal level. Trust me, it's not that easy but here is how it can be done:

1. Introduce yourself. "Hi I'm Phil. What is your name?" - they will usually reply telling you their name. DON'T write it down in front of the patient unless it's a formal conversation! If you didn't catch it you can ask again immediately after otherwise wait for the end. If you don't think you can pronounce it, either ask them now or wait until the end of your conversation!
2. Small talk. Start with the weather, if they're enjoying the clinic, where they're from and you can tell them where you're from too. Use their name in conversations and repeat it over and over in your mind.
3. Actively wait for a 'tell'. Just like in poker when a player unknowingly makes a gesture that suggests a poor hand of cards. Only, for the patient this is likely to be some detail that you didn't specifically ask for (or were expecting them to tell you). I liken it to a 'tell' because a few patients don't readily give away information about their personal lives (e.g. that they have a grandchild).
4. Find out as much as is appropriate from that 'tell' and look for another 'tell'. The more you find out, the easier you will remember them as a person and not a condition.
5. Thank them for the nice conversation and write their first name down (when you're out of their sight). Bear in mind not to write anything else as not to breach confidentiality if your piece of paper gets lost! If you cannot remember their name, ask them again at the end.

S2W5: Home Sweet Home

Knock.. knock.. knock... at the flat door... "Hi, we're here to see the flat!" Yep it's that time of year again. Landlords are re-listing rental accommodation for the next year and students are busy viewing the listed properties. You can often identify these people because they're roaming the streets in groups with a map leading the way (the map being the distinguishing factor between flat hunters and students heading into town to down some drinks). Unfortunately there are no early bird specials, but it sounds like a good idea to first year students regardless. My current landlord decided to renovate the bathroom without our consent or giving us any formal notice this week. I don't think any of us living here were surprised because they had painters working outside our bedroom windows for most of last week without any formal notice too. Anyway, apparently now is the time to start flat hunting! My tip for surviving physio is to choose the best possible accommodation that you can call "home" for the year. Here is a brief check-list:

• Warmth
• Sunshine (especially in winter)
• Insulation of walls, roof and underlay under carpet
• Double glazing & Low ceiling
• Well fitting doors and windows - no leaks/water stains on the ceiling
• Heat pump or fireplace 
• Ventilation: extractor fans & windows

• Location
• Proximity to university, work or supermarket
• Neighbourhood
• Hill vs Plateau
• Car parking (free!?)
• View from inside out and from outside in.
• Other obligations e.g. having to mow the lawns?

•  Costs & facilities
• Cheap Rent & Bond
• Cheap Power, Gas & Internet
• Furnished vs Unfurnished - check walls and curtains for mold!
• Quality of features e.g. energy efficient appliances, smoke alarm and clothesline
• Friendly Tenants
• Good Landlord

This is my second week at a community physiotherapy placement. The chronic diseases class is held at Unipol, which is the student's gym at the University of Otago (free entry with a current student or staff ID card). Unipol backs on to Forsyth Stadium, a covered sport stadium for mainly rugby and soccer matches. During the placement half of the student physios contributed to a great warm up and cool down. I will be contributing to this next week with the other half of the physio students.

In many ways, University of Otago is like Hogwarts. There are many old buildings (some that look like castles!), many stairways (luckily they don't change!) and secret passages between buildings. The secret (or not so secret) passage to Barnett lecture theatre is always exciting! Barnett lecture theatre is located in the Dunedin public hospital and I feel like this is becoming our second lecture home. I like it because there is an over-bridge between the hospital and the anatomy and physiology department where Gowland lecture theatre is. Let me take you on the over-bridge (secret passage) to Barnett! The lecture theatre itself looks like it was taken straight out of the Harry Potter movie too!!

Phty 254 MSK and anatomy were in sync this week with presentations and assessment of the knee complex! We are now expected to learn the assessment techniques at home before the lab to fully utilise the lab time (perfecting the technique). This means that we partner up as soon as we enter the lab and start mobilising joints. When other students arrive, we test their joints out too! I am always pleasantly surprised to find joints that I previously thought were very well stuck together, actually have a reasonable amount of accessory movement!

Home is not only a geographical place, such as the town you live in, a flat or parents house. Home is a place of personal significance, attachment and comfort. At home this week my flatmates and I are having a potluck lunch on Saturday. I hope they decide to flat together next year! After the potluck lunch I'm travelling to my other home to see my parents - so that's two delicious meals in one day! Lucky me! It snowed again on Friday, so our Pharmacology lecture was cancelled - it was a good idea to stay at home in the warmth.

S2W4: Physio Culture

This week I discovered Pinterest! So I've put up some images that seemed relevant to physio! Looking through the images I noted that there were different cultural ideas associated with the images and so I thought it would be interesting to discuss the culture of physiotherapy, at least superficially for the first two paragraphs anyway!

You may remember different social groups at high school - it probably reflects similarly to the movie "The Breakfast Club" directed by John Hughes. At university we hope to be more culturally aware but we still gravitate to certain people who share similar cultural norms or to fill our own social needs. Just for crudeness sake I'm going to match physio disciplines to a stereotype like in the movie 'The Breakfast Club' (in reality it is not like this at all): private practice musculoskeletal practitioners are the 'Jocks', neurological physiotherapists are the 'Nerds' and cardiopulmonary physios are the 'Princess/Prince'. But in reality we are all jocks, nerds and princess/princes... and probably outcasts too (just like the movie portrays). Note that none of us are criminals! (Parking tickets don't count - we have 'police vetting' next week which shall deem us 'safe' to practice in a clinical setting). As therapists we create our own identity which shows through in our treatments. Some therapists are known to be 'hands off' (that was the case for our MSK lecturer, who appeared to love the idea of not having to palpate the patient) whilst many therapist's touch feels empathetic and you know you will be taken care of. Other therapists have a firm touch and you know there will be no mucking about! Hopefully they don't rip your limb off when clearing joints!

There is a culture within Physio students at the University of Otago to be widely accepting of one another. We're all a bit different, and that is perfectly fine. There is a sense of unity between students. Furthermore, we don't feel pressured to compete against each other for the best marks (like medical students may) which allows us to compete against ourselves and to achieve the best patient outcomes. We are known to share and discuss ideas openly but when it comes to answering questions in class the cultural norm is to hide behind your notes. However there is always a voice or two that has a go - followed by a friendly response by the lecturer. Our understanding is what matters at the end of the day! It's very hard to explain cultural identity when you consider the diverse upbringing of each student and generalise across the student cohort. I could talk to you about cultures surrounding ethnicity, gender, sexuality, socioeconomic status, religion, disability, education... but it'd be too long for this blog. With all these differences, at least we have physiotherapy in common!

Placement! I'm placed at Unipol (the Otago University student's fitness centre) for the chronic disease exercise class (we just call it the diabetes exercise class haha). This placement required some pre-placement reading/refreshing on diabetes and other common chronic conditions with questions being asked before we began to ensure that we understood the conditions.. This is a community class but most participants are referred by their local general practitioner or from Diabetes education through their district health board. I had one patient with poorly controlled diabetes decide to increase their resistance on the cycle ergometer while I was off assisting another patient (my supervisor spotted them working with their HR nearly at their predicted maximal! Oh dear!!)

On Friday morning after our pharm lecture we decided to make the most of the stunning weather by going sand skiing!

Phty254: McKenzie management of low back pain featured this week. We learned about mechanical diagnosis therapy (MDT) for the lumbar region. This was pioneered by the NZ physio legend (Robin McKenzie) that invented the 'lumbar roll'! The lecturer was very keen on us identifying 'derangement', often overemphasising "derangement" in different tones for humorous effect. I was very amused by this. I was also used as a demonstration model for the therapeutic movement which meant continually moving my hips between two postural positions (e.g. hips poking out to the left then right) while the lecturer discussed points. The second MSK lab focused on clinical biomechanics of the foot and prescription of footwear.

Phty250: Muscles of the hip and thigh were covered this week. We were also given an anatomy assignment last week which I think is due next week. I chose to research the adductor longus muscle of the thigh, in particular any anatomical conflicts in the literature. For example, the adductor longus muscle is not reported to have fibres attaching to the rectus sheath at the proximal attachement in anatomy text books, however in dissection studies the fibres are said to be fused (this could have clinical relevance for patients with groin pain).

Tip for surviving physio: backup your electronic assignments to a cloud service like Dropbox (or email them to yourself). My flatmate lost her assignment due to a computer malfunction - lets all learn from this and prevent such a disaster happening to ourselves!

Phty252: The pharm lab this week had us physio kids consuming drugs (well... one drug)! We were measuring heart rate and peak expiratory flow rate after low and high intensity exercise, then again after taking metoprolol! Metoprolol is a b-Blocker which decreases heart rate and heart contractility. There is nothing much to add here (you can probably guess what happened to our measured variables). I think it is interesting that the pill is heart-shaped! The stamp is for the unlikely incident of an adverse reaction - it is so the medical staff know what we had consumed. The lecturer supervising the lab had a keen sense of humour; we were talking about the assignment which required looking up drugs on MIMS or Medsafe, "In my day I use to walk to uni in the snow... wait that's a different story! In my job I look up drugs every day that I don't know about - you should get into the habit too".

I found some physio related memes on Pinterest / internet too! ...

 

 

 

 

 

 

 

S2W3: Roles & Rolls

Role of the physiotherapist - what do we actually do?

Physiotherapists play an important role in the health care team and wider health service umbrella. As primary practitioners (like doctors) we are able to assess, diagnose and treat ailments within our scope of practice. The scope of the physio is very large, from musculoskeletal, neuro to cardiopulmonary and other disorders (like renal) where management of their condition partially comes in the form of exercise, movement strategies etc. Often the scope of practice of a health care provider overlaps with the that of other health care providers. As a consumer of health services, you should decide to what extent you trust the clinicians educational basis for treatment... for example, if a soft tissue therapist told me they were altering my muscle "cell memory", I would be very suspicious! I will list and describe different health care providers briefly (hopefully without undermining their health profession). We haven't had a lecture on this as of yet, but this is my current understanding.

• Doctors/physicians. In western society, Drs lead the health care team. Although autonomous, physiotherapists must refer back to the doctor in some circumstances such as suspected cancer, ordering X-ray imaging and when we think medication may be beneficial. Drs usually refer to physiotherapists for diagnosing physical ailments like sprained ankles, and then physios may refer the client back to the Dr or a specialist (orthopaedic surgeon) if we suspect surgery is necessary. Doctors don't usually offer exercise prescription or physical rehabilitation, rather they use pharmacological agents to interact with biological processes to improve health outcomes.
• Occupational Therapists. OT's are all about functioning at home and in the community. They assess and initiate the modification of living areas or teach clients to move more effectively in certain environments or with aiding instruments/tools (such as transferring). Some common ground include prescribing ambulation aids and using hoists. If physio's can teach client's to move, OTs will teach them to dance! OT's also are trained to test some neurological disorders, similar to physiotherapists.
• Chiropractors seem to come in two flavours; traditional/philosophical and biomedical. Physiotherapists and chiropractors have slightly different histories/philosophies but are both trained to manage musculoskeletal conditions. I believe the biomedical orientated variety have become similar to physiotherapists over time. Chiropractors are spine adjustment specialists but also work on soft tissues and other joints. Physiotherapists are very exercise/function orientated with techniques to manipulate the spine and techniques to mobilise joints and soft tissue. Physiotherapists, with further training, may practice acupuncture (this may be considered alternative medicine) whilst chiros have their own alternative methods/tools.
• Osteopaths use manual therapy and mobilisation techniques like physios and chiros do. Historically, chiropractic roots lie with osteopathic practice. All three professions, in the musculoskeletal realm, claim to offer similar treatment outcomes and a holistic approach. Of the three, osteopathic medicine is the one I have the least knowledge about. In New Zealand it is not uncommon to hear health professionals refer to osteopaths as 'Gypsies' - but we certainly do respect their practice.
• Acupuncturist. As the name suggests, they practice either western or eastern acupuncture medicine. 
• Psychologist. We are taught some psychological techniques for motivation, managing stress and anxiety. Physios only manage mental health issues when they co-present with physical rehabilitation or training. Physios consult with psychologists on delicate situations and often refer the client to psychologists or counsellors when it is believed to be in the best interest of the client.
• Podiatrist. Lower limbs and feet can be considered to be the foundation of our postural health (did you see what I done there?!) Physiotherapists and podiatrists can prescribe splints and wedges to adjust the position of any lower limb joint. Podiatrists specialise in the care of leg and foot; from clinical biomechanics (with prescription of a certain shoe/insole) to the care of the skin (managing corns and calluses - this is something physiotherapists don't primarily manage).
• Soft tissue therapist (massage therapist). Physios know how to massage, the principles, contraindications etc. Our focus is on therapeutic effect and our understanding of the body as an integration of multiple systems allows us to work with wider scope than that of a massage therapist. Massage therapists can often specialise in a style of massage (like Thai massage) - this is something physiotherapists don't usually consider being trained in. We apply the necessary strokes/techniques to impact physiological and psychological parameters. Some massage therapists are more 'in tune' with soft tissue than physios due to their specific discipline and hands on patient contact. Both physios and massage therapists learn about trigger points and soft tissue manipulation.
• Personal and high performance trainers. Physiotherapists know a lot about exercise and health, much more than a personal trainer. Physios know about high performance too, but generally leave that to specialised trainers who have industry knowledge and can better apply training principles for specific peak performance. However, injury prevention and rehabilitation falls almost exclusively within the scope of a physiotherapy or in collaboration between both parties.
• Speech language therapist. Physiotherapists recognise the neurological and physical aspects of speech disorders like a speech language therapist. We can help the client with TMJ pain and problem joint kinematics. However physios leave sound articulation and mastication training to the speech language therapist.
• Paramedic. Paramedics provide first aid. Physios don't attend to first aid incidents in the community (unless physios are already on-site and basic first aid can be given) but generally work in a similar capacity in a sporting context.
• Sport Medic, Sports Paramedic, Sports Physio & Sports Doctor. This is the medical team that attends major sport functions. There may be a nurse amongst the team too. Sport medics apply basic first aid, strapping, massage and are the support hands to any other health professional in the team. Sports paramedics are qualified to complete any emergency medicine but most of the time they will be suturing up lacerations and possibly even relocating subluxed joints. Sports physiotherapists are experts on strapping, massage, therapeutic exercise and return to play. Sport/team doctors are the leaders of the health care team.

Some people roll with their pants (most commonly jeans) halfway down their bottom when they walk. ["Roll" =  it's their style]. According to our anatomy lecturer, people who do this are in danger of compressing their lateral cutaneous nerve of the thigh (also the risk of their pants slipping off their bottom). If they feel pins and needles on the lateral aspect of their thigh, our treatment plan would start with them pulling their pants up!! (A walking/transfer belt would not be suitable).

Foam rolls in hydrotherapy are called 'noodles' and they can be used to stop us from rolling (rotating in the water) by increasing the radius about our longitudinal axis.  Other rolls in the pool were rolls of adipose tissue - especially mine! I rationalise this as a mechanism for insulation (but I should look at adapting my physical composition in preparation for summer!) This was our last week of hydrotherapy. It finished with an assessment where we were given a case study and had to integrate principles of hydrotherapy into a rehabilitation plan. Our case was a 35 year old female tennis player with rotator cuff tendinitis - we were given more details than this though.

Foam rolls are like 'noodles' (only more solid) and are used on land to massage / stretch our IT-band (amongst other muscles e.g. gluteus muscles). Those who haven't used it regularly will think it is slightly tortuous! It is particularly good for an athletic population because tissues need to be stretched and often stretching won't have the same effect as IT-band rolling. Other rolling strategies that are effective are to use a tennis ball under the sole of the barefoot, apply some weight to the ball and roll out the plantar fascia. Give it a go when you have the opportunity!

At the beginning of this week I was busy using a toilet roll / paper as tissues! Yep. I had another cold. Thankfully it is on its way out. I'm actually surprised about how many 'rolls' I managed to talk about! There are other rolls which I may cover in future weeks e.g. Lumbar rolls to support the lumbar spine lordotic curvature and the Million Dollar Roll which is a lumbar vertebrae manipulation technique.

Many of the lecturers, especially lab and clinical placement staff for 254 and 255, are wonderful role models! They bring wisdom and passion to the field of physiotherapy. It is truly inspirational for us students to observe and interact with them. I have mentioned this before (with one lab demonstrator learning all of our names), but now that the year has progressed it is clear that most of the lecturers want to help us achieve a high level of practice. Not only this, but they treat each student as individuals and interact with us on a semi-personal level.

PHTY254 Neuro required the class to assess a few neurological conditions, such as multiple sclerosis and stroke patients, rolling from a lying position onto their side (side lying) then into a sitting position. This was part of the objective assessment. Our aim is to make everyday tasks easier by providing strategies to move, increasing their strength and mobility. This is the last week of Umove for me this year. Next week I begin my second placement!

We have an electronic resource for tests of the upper and lower limb (previous years were able to purchase a DVD - so I borrowed it because our internet is slow!)

I've found some more vids!! Have a good weekend!

S2W2: Snorkle.

Just for a change, I'm going to highlight all the fun things we did this week (and are looking forward to) starting with our PHTY254 lab on hip examination. When examining the hip we want to either clear it as a source of pain or document what specific movements bring on the pain. To clear the hip we perform tests, for example the 'quadrant test', 'SI joint provocation test', 'isometric tests' and through 'active physiological movement with overpressure'. The second PHTY254 MSK lab taught us special orthopaedic tests (joint integrity tests), neurodynamic tests and neurological examinations. These practical labs are fun. They are hands on but most importantly they are meaningful skills used by physiotherapists.

Umove was good fun this week. It was quieter in the first hour which meant we were able to play with a few toys in the lab! Toys included an air-splint (would be ideal for inflatable suit wrestling), a tilt-table (strap the client in and tip them from lying to standing position) and we also played darts (magnetic) and badminton! Good fun! I had a different client this week (yes we done some work too). The client was able to show me what he was able to do / had been doing, and I was able to introduce some new ideas for improving left quadriceps strength.

The pharm lab explored some of the foundations of pharmacokinetics; bioavailability, distribution of volume, half life, plotting semilog graphs and effects of multiple dosing. It was an interesting lab and I can certainly see how pharmacology serves an important role in physiotherapy care even though as physiotherapists we cannot prescribe drugs.

We've had some interesting quotes this week from lecturers across subjects. "The sciatic nerve is so long and strong that you could hang yourself with it" - anatomy. A little insensitive, but it's true that it could hold our body weight! "42 cups of regular Starbucks coffee will kill you" - pharmacology. This was with reference to caffeine and the therapeutic index... "You will not be able to commit suicide using a drug with a large therapeutic window, e.g. therapeutic index of 40". What a grim week! "Groin Clock" - PHTY254; does not refer to a time where your groin has certain urges!! Rather, it refers to angles of femur placement within the acetabulum - the quadrant clearance test of the hip.

Physio is a social professional course and as such, the social events are continuing this semester. Tip for surviving physio: get involved with social events. They usually involve alcohol, but that doesn't mean that you have to drink too. Hang out with your peers and enjoy a few laughs. These posts are aimed to motivate us to be involved whilst providing a humorous undertone. Semester two inter year (2nd and 3rd year) lab group BYO is on the 6th of August! Physio is very social!!

Cultural dinner on the 30th and Miss Physio Competition next Friday!! 

Here is a more detailed post about the Miss Physio comp!!

The physio ball will be held in August, so I'll tell you about this social event closer to the time. Wait... how do you spell physio?? Haha!!

Physio vs Physical Education girls rugby this Sunday!

Clinical debrief is all about sharing and learning from one another's experiences. It highlights the importance of presenting a case, which will be useful in seminars or in 3rd and 4th year when consulting our supervisor. Presenting cases is a skill that I will continue to work on... documenting all the relevant information during the clinical placement would certainly help me with that haha!! I heard about other conditions that my peers encountered on their placements such as TB, low back pain and Crohns disease. Very interesting!

The premier grade Dunedin Technical Football Club players, manager and coaching staff have given me a nickname. I have no idea how it came about, but I'll play along. It's very creative. "Snorkle". It's good to be a part of the team!

During the hydrotherapy session we put knowledge / principles about hydrostatics and hydrodynamics into practice. Did you know movement in water is 799 times slower in water than it is in air - due to skin friction drag and the resultant effect of the weight of water. I'm thinking that the nickname 'snorkle' would be ideal if I were good at holding my breath underwater - unfortunately although I am a good swimmer, my breath holding abilities are average. I'll figure the whole nickname thing out some time, haha!!

In other water related events going around social media, I completed the Ice Challenge for cancer awareness with my girlfriend (we were both nominated by her friend).  We completed the challenge on St Kilda beach at 6:30pm (which meant the sun had long set) and after brief rain showers throughout the day. The challenge itself involves having buckets of ice water (water with ice in them) poured over your body. To finish the challenge we decided to go for a dip in the ocean! It was a chilling experience!