Chi Kung for osteopaths / EMC / Manus reflection / Pilates

It was getting far too close to the dissertation deadline to be doing anything enjoyable, but I had booked this ages ago. It was ok, but I think I expected something totally different. I wasn't in the mood to pant heavily in my chair, then get up and jump up and down, but it was definitely invigorating! Despite being my age, I had to stifle childish laughter half the time and I felt like a nasty old cynic. I was in fact very interested, but the timing was all wrong - I really should have stayed at home with my life's work... I owe it to devotees of lymphatic drainage techniques everywhere.

Certificate of attendance - 1 day Chi kung course

EMC tutorial notes - Fantastic!

I am LOVING EMC. Our tutor is incredibly giving and her enthusiasm is inspirational. It is also a great opportunity to use the techniques from the obstetrics elective.


19/2 Manus reflection

I have managed to attend the Manus talks with Rupert Sheldrake and Averille Morgan this term. I appreciated what Averille was saying, but the presentation wasn't really my cup of tea. Rupert Sheldrake, however, blew me away with his morphic resonance theory. I will not be attempting to explain it here, but I am definitely going to buy his books. I am extremely susceptible to this sort of discussion, but I do find it fascinating and here was a scientist with what sounded like some hard evidence, which usually is what is lacking, Amazon, here I come.

Pilates

I have been attending a 6 weeks beginners course and I can really see what all the fuss is about. I definitely want to continue with this and would like to be able to teach some of it to patients one day.

Shoulder / Elbow

Annotated Diagrams; Technique and Clinical anatomy revision cards - Elbow

Annotated Diagrams; Technique and Clinical anatomy revision cards - GH, AC &SC

Annotated differentials textbook - Shoulder

Clinic reflection

I have had a few interesting situations in clinic since term began.

The most memorable being my worst patient encounter ever! I innocently approached a re-exam for a long term patient by starting with a completely new history. The lady was booked in for the assessment by my colleague who was unexpectedly unable to take her at the last minute. It transpired that she did not want this to be happening at all and did not want to answer any questions! She felt let down historically by the medical profession and undeniably had suffered some unfortunate side effects of medical treatment and it became obvious early on that there were yellow flag issues and she hadn't really been taken care of properly. She was extremely hostile and aggressive in her manner and I initially tried to call a halt after about ten minutes. We decided to carry on, but again, after another twenty minutes I stopped taking the history for good this time. I had been on the receiving end of this womans' rage and frustration for too long and she was crying now anyway. A failure of reflective listening! I calmed things down and brought in a tutor who decided we would treat conservatively and worry about the re exam later. I was glad when she left and I referred her back to my colleague, having fully debriefed him!

This is the only time I have really struggled with patient empathy. During the encounter I just found it unbelievable that someone would behave like that and not offer an apology. I felt like an emotional punchbag. I was very disturbed by this encounter and although I can be objective and have some sympathy for the state she has ended up in, I am left with a residual feeling of disgust. I need to work on being prepared for other situations like this so that they do not affect me personally. I should have no residual feeling about this encounter. I feel that I wasn't detached enough. However, it is of slight amusement to me that during a calmer dialogue when she genuinely opened up, I had asked her about her support network (she didn't have one) and suggested that maybe talking these issues through with a professional would be beneficial, only to be BELLOWED at again. The sound of her shouting at me that, "talking about it all was the problem," is still ringing in my ears. I am scarred for life!

The tragic emasculation of british osteopathy (MW)

4/2 Mervyn Waldman course

A whole day of inspiration. I must get hold of the slides. Lymphatic pumping techniques demonstrated live! (Relevant to my dissertation). Amongst other things...

The presentation was based on Stills' two fundamental premises of disease:

1. There is often a somatic component to disease
2. Effective manual treatment of the somatic component, may play a significant role in enhancing immune response and recovery from disease

It was an incredibly interesting approach and right up my street. This couldn't have come at a better time - I am really flagging and feared my enthusiasm was lost forever!

Paper recommended by Mervyn Waldman - very exciting!

3/2 Such an inspirational Manus talk by Mervyn Waldman that I immediately enrolled on his one day course tomorrow!

Cervical Spine

I really want to be good at these techniques. General cervical spine is passable, although left handed techniques are weak; C/T is coming along, but the supine HVT is proving elusive and as for O/A, I found a way that worked for me, thanks to a patient tutor, but then we were told we weren't allowed to use it. DISASTER! I have had no success since. This is torture.

O/A - Annotated diagrams / notes

C/T - Annotated diagrams / Notes / Technique summary

Annotated diagrams; Technique and Clinical anatomy revision cards - Cervical spine

Annotated differentials textbook - Cervical spine

EMC Tutorial

Again, I find myself preparing for a tutorial, along with my colleagues in EMC this time. Public speaking even in a small group terrified the life out of me in first year. If there is one change in myself that I have really noticed, it is that this is getting easier. I still hated it at the end of third year though and just watch me at the end of this year! No doubt I will be eating my words. Something has changed though, I just can't put my finger on it. My contribution is below:


Pre-eclampsia – the most common of the dangerous pregnancy complications

AN EMERGENCY

Can affect mother & child

Typically occurs after the 20^th week, is considered early before the 32^nd week & can occur up to 6 weeks post partum

3 main characteristics:

1. Sudden hypertension

2. Proteinuria - Large amounts of protein in the urine due to glomerular endothelial cell swelling

3. Generalised oedema

Other signs & symptoms can include:

Blurred vision

Headaches

Pre-eclampsia may be related to an autoimmune or allergic reaction. Substances from the placenta can cause endothelial dysfunction in the maternal blood vessels of susceptible women. While blood pressure elevation is the most visible sign of the disease, it involves generalized damage to the maternal endothelium, kidneys and liver with the release of vasoconstrictive factors being secondary to the original damage.

Many studies have suggested the importance of a woman's immunological tolerance to her baby's father, whose genes are present in the young fetus and its placenta and which may pose a challenge to her immune system

Continued exposure to a partner's semen has a strong protective effect against pre-eclampsia, largely due to the absorption of several immune modulating factors present in seminal fluid.

Long periods of sexual cohabitation with the same partner fathering a woman's child significantly decreased her chances of suffering pre-eclampsia. As one early study described, "although preeclampsia is a disease of first pregnancies, the protective effect of multiparity is lost with change of partner.

The term Eclampsia is used when the condition is also associated with convulsions & coma

Acupuncture / Inspiration

Occasionally I see my acupuncturist - what used to be a monthly blow out, is now a very rare treat - or emergency! This is a lesson in how I would like to be as a practitioner and this time I am viewing it as a practice visit. I can't describe what this experience does for me. When I ask how I can learn, he just says it is all about intention! Oh, and lots of meditation and chi kung. I suspect there is more to it!

Interestingly, in seven years, I have never asked what he is doing or why and he never volunteers the information either! It is a very peaceful 45 minutes. Serenity. This is the effect I want to have on my patients.