Clinic reflection

A patient presented this week with a proper lymphoedematous leg. Hurrah! She had inguinal lymph nodes removed following skin cancer in the leg five years ago. This has confirmed that I really want to learn the specialist manual lymphatic drainage techniques for oedematous conditions (as well as the osteopathic lymphatic pumping techniques which are focused more on immunity). The LEX was heavy and becoming debilitating - she could barely bend it at the knee. There were several other problems, but I was most frustrated by the limb and knowing that there is so much more I want to be able to do for her. I did manage to apply two of the soft tissue techniques I learned in the weekend course in November (VF) though.

I also heard from a colleague who saw a new patient of mine from a couple of weeks ago. Both he and his tutor felt that a completely different diagnosis was more appropriate than the one I came up with (which was actually decided mainly by my tutor, as I genuinely wasn't sure what was going on). They thought that early degeneration of the hip at 51yo in a personal trainer was most unlikely. My tutor had discussed with me that this was the most probable cause of the symptoms at the time. I find situations such as this extremely frustrating and this is exactly what makes me have my doubts about the whole thing!

I dread the 4.40 or 11.40 new patient slot, as I feel there is even less time than usual to discuss ideas and the diagnosis with tutor afterwards. This wouldn't happen at AECC! I did really like the way they booked time with their senior tutors to discuss new patient management plans and get questioned about their diagnoses etc before the patient returned to commence the plan. I had a complex acute patient this week and was not happy at all with the diagnosis I ended up getting signed off at 6.05, but I had no choice and amended it accordingly.

I was also blasted during a returning patient presentation recently, for no real reason other than the sound of my voice I think. It suppose it is just about getting used to tutors again, now we have swapped days, but I felt like a mouse being tossed in the air by a menacing cat. This is something I can laugh off now, but sadly, I realise with hindsight, that actively trying to avoid this sort of encounter in the past has possibly meant I missed out on learning opportunities - even if they did come with this sort of price!