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Complaints through GOsC - communication +consent

Functional Goal setting

HVT explanation and consent gaining

Consent for an SPD patient

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Practicing HVT's

Gap in knowledge - Paediatric orthopaedics

Gap in knowledge - medications, their methos of action, uses and side effects

Gap in palpatory skills - Cervical spine

Bob Shaw CPD

Lycahealth CPD - talks by orthopaedic and neuro surgeons

Self-reflective practice

Developing the depth of my palpation

Tutorial on Groin Pain classification

Getting my head around UMNL vs LMNL

Babble of a busy brain

Establishing the Mill Pond

Taking the leap into the abyss

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First Aid Certificate

Routine framework

Thinking 'Outside the Box'

CCA1

CCA1 Post-exam reflection

CCA1 Examiner feedback

CCA1 Feedback summary + Action Plan

Keeper of Time - Action Plan

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Directful insistent patient

Progress

Children and Maternity clinic Term 2 feedback

Pause, Collect, Continue...

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Year 1 10-minute write-up

Year 1 Physical evaluation assessments

Year 1 Practical exam 3 stations

Year 1 Physiological studies essay

Year 1 Results

Year 2 term 1 Action Plan

Year 2 Physical evaluation assessments

Year 2 GMS assessments

Year 2 Physiology essay feedback

Year 2 Pathology exam

Year 2 Clinical Neuro assessment

Year 2 OCE essay feedback

Year 3 Formative and summative LEPB's

My first patient in clinic

My second patient in clinic

My third patient in clinic

Year 4 Action Plan Children's Clinic

Year 4 Summative LEPB

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Complaints through GOsC - communication + consent

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Complaints through GOsC - communication + consent

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Through reading 'the Osteopath' from the GOsC, I have been recognising trends in causes of complaints made against osteopaths. The most significant, relate to communication and consent between patient and osteopath. This has made me aware that if these are aspects of clinical practice are often not up to a high enough standard, that I should practice now, to make sure patients understand the information they need and are given, as well as valid, informed conset to treatment.

(OPS: A1-6, B1-4, C1-7,9, D4-7)

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Influences of Occupational Therapy and integrating into a more holistic clinical practice

Through networking with an occupational therapist colleague, we discussed how best to approach patient management. It was concluded that rather than judgement of pain (which may be one of the most significant aspects of a pateints presentation), the loss of function (most commonly during day-to-day activites such as hygiene, eating, drinking, dressing and work-related activity) were imperitive to resolve.
Through Functional Goal setting with the patient, i.e. treatment aims of restoring basic functional ability, there should be a greater sense of acomplishment , both through communication and patient/practitioner partnership.

After basic function is regained, recreational function goal setting would be next on the priotisation, e.g. reduced pain when passing a ball in a game of football.

(OPS: A1,3,5,6,  B2-4, C3,7, D1,3,4)

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Practicing HVT's + functional goal setting

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I found that during my first clinical year (3rd year), I was very unprofessional with the way in which I would involve the patient and their consent prior to performing any HVT. This ranged from explaining the technique itself and the benefits, to the potential advsere side effects.

I found that at that time, even though patients would show improvements, the overarching professionalism and patient-practitioner  relationship was much less patient-centred. While this could be considered as myself working towards the patients best interests, it is not a shared decision-making process, which not only fails to meet OPS standards, but lacks in what I and the profession would consider to be sustainable acceptable practice.

Now in my second clinical year (4th year), I have been utilising the shared decision-making process much more readily with every patient. This has showed a vast difference in the way in which the patient appears to feel increasingly empowered, by having a say in the technique approach they would feel comfortable with, but also being made aware that there are alternatives to the HVT technique, which will still have similar effects.

I have found that actually while it may seem more work to present the spiel about alternative technique approaches and benefits/ side effects, it not only covers myself from a professional and legal perspective, but it makes the entire patient management process much more seamless. Involving the patient in decision making along the way allows the creation of a much more open and honest rapport, which can be fed-back to prospective patients by word of mouth etc. In my own experience, I have heard friends and family members complaining that certain practioners would perform techniques that the patient didn’t feel comfortable with and they appeared to feel less empowered over their own health and prognosis. This is something that I aimed to address within my own clinic practice.

As far as the future is concerned, I wouldn’t think twice about falling short of emphasising the decision making process as a key element of the way in which I would work, as I have seen the way in which it has changed my own way of working at an undergraduate level.

(OPS: A1-4,7, B1-4, C1, D3)

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During Maternity clinic, a new patient presented with classic symptoms of SPD.

This patient was my first I had to get written consent for, used for assessing the pubic bones and pelvic floor muscles.

The informed consent process was such that I ensured the patient was already aware of the cause and process of her presention in a way she could understand. The reasoning for consent, and why those regions were necessary for assessment and potentially treatment.

After I was confident that the patient had expressed her comprehension of the process and justification, I continued to perform my relevant assessments.

It would transpire that the treatment (involving mainly indirect, with some direct approaches), would provide a significant level of relief over the subsequent 7 days, alongside other techniques of associated regions of the body.

I felt at the time of valid informed consent gaining, that the process was one which would be robotic and somewhat tedious. However, afterwards, I realised that it was nothing of the sort, that it would actually strengthen the trust and confidence of my patient, my justifiaction of how these regions related, fitted in with her own beliefs, which she had come across  from other walks of life.

In the future, it is clear to me, that as long as I have a watertight diagnosis and justification for which, and the ability to decode the medical language into laymans terms, this will make for a smooth consent gaining process.

(OPS: A1-5, B1,2, C1-4,6, D3)

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A recurring theme at clinic is the need to practice HVT's, often due to the fact that I infrequently find myself using them with patients. I believe this is due to the current cohort of patients I have, most of whom are not warranted an HVT or have an underlying condition which would potentially cause difficulty or pain attempting to do so.

I do, however, realise that if a technique approach is not practiced, it may become imperfected, and thus, I would not be providing the highest standard of technique for my patients that warrant an HVT as part of a treatment approach.

Recently, I have been ensuring I practice HVT's on and with members of my and other clinic groups, providing and receiving feedback to aid in mine, and my colleaugues learning.

I have noticed that when performing HVT's more recently, I have become more fluid in my setup, and increasingly aware of the patient infront of me, and how it might require me to adapt my hold.

(OPS: A2,5, B2,3,4, C2,3)

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Practicing HVT's + functional goal setting

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Gap in knowledge - Paediatric orthopaedics

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Gap in knowledge - Paediatric orthopaedics

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During Summer clinic of third year, I felt I was lacking in my paediatric orthopaedic knowledge, and so felt it was necessary at the start of children's clinic to brush up on my skills, by reviewing class notes, and watching videos online to break down the information in a clear, visual way.

I was adament that if I was to get a patient with a common condition or showing signs of, then I should be better equipped.

(OPS: A3,5,6, B2-4, C1-3,9, D1)

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Gap in knowledge - Medications, their method of action, use and side effects.

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Gap in knowledge - Medications, their method of action, use and side effects.

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Since starting Pharmacology in second year, I have found getting my head around medicines and drugs a minefield of information.

I had bought the BMA guide to medicines and drugs, and yet again, the visuals, as well as the well presented bitesize snips of information, made it feel as if I had unravelled my conundrum.

The guide itself made the ability for me to make connections between drugs taken and symptoms the patient is experiencing easily recognisable, to assess whether or not what they present with is something I could help with.

(OPS: A2,3,5,6, B2,3,4, C2,3,7,9, D1,3)

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Gap in palpatory skills - Cervical Spine

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Gap in palpatory skills - Cervical Spine

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I only really started to be able to understand what I was feeling of the cervical spine at the end of year 3.

This is purely down to my aprehension earlier in the course to engage with practice of that area, due to my fear of cervical wheels, introduced at the beginning of year 2.

During year 3, Philipe Raynaud provided me with a 1-on-1 tutorial on palpating the C-spine, diagnosing osteopathic lesions based on fryette, then manipulating them using the fryette concept. Ever since, I have had no problems putting them through, with continued practice.

One school of thought that Mr Raynaud mentioned to me, is that If, on setup of the manipulation, I felt it wasnt focused enough, likelyhood would be that the patient would feel that too. In such a situation, re-setup and a brief spiel to the patient that I would reposition to ensure I wouldn't have to keep trying to force it to go. This idea would, in theory, help the patient have more trust in me as a professional, and hopefully make them feel like I see them as a patient, rather than just a spine to 'crack'.

(OPS: A1-5, B1-4, C1-5,7)

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I learned how important being confident in yourself, your own practice, and not allowing any elements of ego to affect the patient-practitioner partnership.

This course changed my approach to clinical life tremendously, I now feel much more confident dealing with patients that I would have previously found hard to manage, in terms of their expectations, and managing difficult EGO states (such as parent-child/adult).

(OPS: A1-5, B2,3, C3-7, D4,16,17)

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LycaHealth CPD - Talks by Orthopaedic and Neuro surgeons

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LycaHealth CPD - Talks by Orthopaedic and Neuro surgeons

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Opening my professional mind to the reality of the work that other healthcare professionals carry out and how I can learn from their experiences.

This CPD talk opened my eyes to not only a current report on how surgical procedures are carried out for low back and hip pain, but also the rolw of orthopaedic testing in a surgical setting. I found that even surgeons would visualise the anatomy

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ertificate

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I feel as if occasionally I forget time is of the essence and that I have a lapse in my framework in a case history.
Time management and efficiency, lead by having a general routine for regions of the body and for orthopaedic conditions will be practiced.

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Unlike Adult clinic, where I have had  a longer experience within, I have often caught myself taking a case history for a baby patient in a way that felt more of a box-ticking exercise, where I would endeavour to follow a structured, pre-made path of questions. This may well be because of lack of experience and/or sufficient knowledge to delve confidently into follow-up questions.

In the initial consultation for this 3-week old boy, I found myself throwing away the idea of following a rote set of questions, and instead, allowing the parents' story to unfold, whilst following up with relevant questions. Ironically, executing the case history process in this way gave me an abundance of information, which informed my differential diagnosis process in a way which I hadn't experienced in childrens clinic before. I was able to piece the story together in a way which allowed me to not only understand the timeline of events for both parents and baby, but to inform with clarity, the justification for my differential diagnoses.

(OPS: A1,2, B2,3, C1--5,7,8)

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Patient presented to me in my 1st clinical year with no pain or loss of function, only that they felt that they needed their spine manipulated in specific locations.

For me, this was something I was not yet used to as a student in clinical practice, rather more like a student-student interaction.

For me at that time, I wasn't sure how best to approach this patient, as pain was the chief symptom and function loss (due to pain) was the sign which directed lines of questioning to conjure up a diagnosis.
Without either, at the time, I felt flustered that such a patient would present at all.

I remember assessing the patient and locating restrictions of axial movement, which I affected by using spinal manipulation and soft tissue massage.

Even though I had made improvements in function, this patient was extremely insistent about my treatment approach, which made me feel as if I had lost touch with my osteopathy.

In hindsight, and looking into the future, the way to overcome such an obstacle, would involve heavy management of patient expectations of what I, as an osteopathic practitioner, would do for him.
In clinical practice, I would first and foremost never want to sacrifice my osteopathic philosophy to become a generic manual therapist.

In this example, it is clear the key theme is communication, and the rigorous lack therof, which inevitably strayed the treatment session into a patient-led rather than patient-centred approach.

(OPS: A1-5, B1-3, C1-5,7, D4,7,14,17)

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Managing self-confidence and professionalism in ensuring the upmost care is given for the patient

I had a turning-point moment in my own clinical reflective journey, when one of my patients did not improve at all after 2 weeks of one of our sessions. As well as this, I could not successfully put through a thoracic manipulation which I had not tried before on him.

This really disheartened me, and at the time made me feel my techniques were inadequate. Even though my intention was focused and I had explained my process to my patient, there was still no change. I hadn't really come across this issue before then, and so I was naive to the fact that, sometimes, the patient's body just isn't in the right state to receive a manipulation.

This experience also led me to consider how there are many factors which will influence the type of technique used on a particular patient on a particular day, from what is necessary, what the patient feel comfortable with, what the patient’s body feels it needs and what is safe to perform on the patient, all of which, when channelled through communication will make for a much richer patient-practitioner partnership and a stronger sense of trust in the patient.

(OPS: A1-5, B1-4, C1-5,7, D4,7)

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About halfway into the second half of the second term of Year 4, I seemed to finally find my feet in communication, time management and being an autonomous clinician.

This new patient spoke very little english, and so at that point, I felt an opportunity to practice making my language as clear, simplified and concise as possible, to ensure, saving time and increase time efficiency. This flowed from the case history taking, the examination, explaining the diagnosis, the consent-taking prcocesses and during treatment.

I found this particular experience invaluable in creating a foundation for future interactions between patients, in order to save time and ensure clarity and comprehension within the patient-practitioner partnership.

Another key aspect of this case, was my improvement in moving patients on when they begin to give 'nice-to-know' rather than 'need-to-know' information during the case history, another skill that I was severely lacking in!

Having recently had my 3rd encounter with this patient, It has become apparent that the pain and symptoms she was experiencing had not changed since the beginning. The patient had said  that after the second session, post-treatment, her symtpoms were minimal, almost nothing, yet in the third session, she made it seem as if it didnt help.

I had found myself getting worked up, trying to uphold the standard I held on the initial consultation. I did what I felt was most appropriate, which was to ask if she had done anything different or excessive than usual, then I proceeded to retest the initial diagnosis, to ensure I wasnt leading myself down the garden path.

After I was happy that my diagnosis was watertight, I proceeded with treatment, to which the patient seemingly responded well.

I will endeavour to ensure that at all stages of a consultation, the language I use to explain, describe or instruct is clear, in order to ensure proper, management can be laid out for the patient

(OPS:  A1-4, B1,2, C1-4,7, D14

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The first clinical competance assessment proved to be a real mix of emotions for me.
Before going into the exam, I was surprisingly confident, calm and collected. I felt as If I had been given a key to a window overlooking freedom - true autonomy.
With my continuing patient, it went just as I had hoped for, I felt in true control for once, looking after the patient as if they were out in private practice outside a training environment. I had memorised the patient like the back of my hand, not overnight, but over the times I had seen her, which made any questions put to me during the exam about her, fairly simple to answer.

The new patient was much the same, I felt mostly in control. I did feel out of my comfort zone entirely, however - having to perfrom in one of the smaller rooms available, accompanied by, at times, two obervers which definitely heated the situation up both physically and mentally. I felt somewhat claustraphobic for one of the first times in my life.

After the exam, I found myself being very critical of my abilities, even if I did make a couple of clinical reasoning blunders, I felt, overall, as if I had perfomed my best, all I can ever give!

Making good use of the blankets provided in treatment rooms

In Year 3, the use of a blanket was used primarily for female patients when I wasn't directly working with their upper body while it was exposed. However, the use of a blanket has become more common with most patients, as the realisation that male pateints can too, become uncomfortable, lying in just their underwear. The blanket brings back not just modesty, but a tool to facilitate the relaxation of patients when they themselves may struggle to let go and relax.

I have found that in the fourth year, the regular use of a blanket, not just for modesty but also for comfort (such as supporting between the knees when lying on their side, especially with patients with Arthritic knees and hips), made a huge boost in the way in which the patient-practioner relationship flourished. Since implementing, I have noticed the patients always feedback that they feel very well respected and cared for.

(OPS: A1-6, B1-3, C1-8, D1,9)

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Recently, I was lucky enough to have a lecture on tissue fields, by Osteopath Gez Lamb.
I went away from the lecture having experienced a significant turning point, development and awakening in my Osteopathic skills.
Up until then, I had endeavoured to visualise anatomy under my hands, which I thought I could feel a lot, picture what I was feeling, however, this lecture sharpened the images I intially thought I was feeling.
An example of body region I felt I had a reasonable sensation of structure and function, was the mediastinum, however, during the lecture, I felt I could visualise and feel between my hands the intricacy of the percardium, the myocardium and the flow of blood through the four chambers of the heart.
The after effects of working on my model's mediastinum, demonstrated subjective improvements from my model, in that they felt they could breathe much deeper and felt an overwhelming sense of calm.
Beginners luck? Most definitely, with a heavy portion of influence from Gez Lamb helped tremendously.
What I really got from this lecture thiough, was a greater understanding of palpatory skills that are at my disposal, that I never knew were there before. With this newly-found 'upgrade' of this skill, I feel I can start to put it into practice with patients, not just in treatment, but with examination.

An important aspect of this experience, for me, was my renewed sense of confidence in my palpation and enjoyment, in connecting with the human body, to facilitate the innate self-healing mechanism.

(OPS: B1,2, C1,3,5,7)

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Tutorial research on Groin Pain classification

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Tutorial research on Groin Pain classification

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Following a tutorial at clinic on groin pain classification, I went online to watch a video to reinforce my learning. Physiotutors is a channel which tends to make information clear, clinically relelvant and Evidence-based and concise.

I found this video particularly useful in categorising types of groin pain, which will make it easier to prioritise questioning in a case history scenario.

(OPS: B2, C1-5)

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Groin Pain Classification in Athletes | 2016 Doha Agreement

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Through 2nd and 3rd year, I had struggled with comprehending the physiology behind the signs of upper versus lower motor neuron lesions, until I came across this video.
As well as this video, this channel had a plethora of other content which aided in my physiology and anatomy knowledge.

(OPS: B2, C1-5)

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Introduction to Upper and Lower Motor Neuron Lesions

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Children and Maternity Clinic - Term2 feedback

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Children and Maternity Clinic - Term2 feedback

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For as long as I can remember, I have had a faster brain than my mouth can process. This often leads me to tripping over my words, both in clinic and with day-to-day speaking.
I have found this significantly hinders my ability to speak smoothly a majority of the time, it also seems to give some people an excuse to cut me up and interrupt me when I am trying to get words out.
This positive feedback loop of poor ellocution and occasional confidence lapsing can make the task of trying to come across as a professional, confident person, difficult.

I always try to have a positive outlook on life and have not yet let this get me down or allow me to stray from my goal of this course - to create the foundations for myself to become the best I can be and help others through my determination and passion.

One way I have tried to overcome the stutter/tripping over of words, is to embrace a long lost talent of mine - acting. When I was younger, I would adore playing a character, often it would be the main character in the play. I would love playing that charcter, because I could throw myself into trying to convey the emotion and become something that I am not.
Now I'm not saying for a second that 'I am not truly a clinician/professional' or that I am pretending, but for a shining moment, when I put on a confidence performance in clinic, I find myself almost believing that I am confident. Slowly but shurely, each time I use this technqiue of imitating confidence, I find my raw confidence is boosted.

I have included a short video clip of a scene from the Film 'Batman: The Dark Knight Rises', which portrays the protagonist, Bruce Wayne (Batman), trying with all his effort to escape a prison 'pit' to which he was cast into by the villain of the film. He tries again and again, only to find himself questioning his will and ability to escape.
I resonate with this scene strongly, as it reflects my own internal battle to overcome a lack of confidence in clinic and my own verbal obstacles preventing me from reaching the surface of my potential.

(OPS: A1, B4, D17)

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Dark Knight Rises - Prison Escape - Complete

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Throughout the course of my time at the ESO, there has always been something to do, whether it is revising, treating patients or attending lectures. As well as the stresses of everyday modern life, my own journey of self reflection has all too often felt impeded by the rest of my life getting in the way of me taking to time to reflect.

Through creating this Padlet -writing down my thoughts, how I felt during experiences and what I felt I  gained from the experiences, I have gradually been able to piece together my own journey of reflection.

The written self-reflective essay I am currently engaged in, is allowing me to create space in my own time to allow me to "Establish the Mill Pond" - into which, I can clearly reflect on the experiences of years gone  by at the ESO.

Reflection itself never seemed to be something which appeared to be a strong investment of time when I first came across it, more of a time-filler for dwelling on the past and judging how it went. However, after setting aside time and really looking back at my experiences which have moulded me into the Osteopath I aspire to be, I have seen the true value to self-reflection.

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I had a new patient recently (over Easter Holiday clinic - Year 4), which really tested me in all corners of my weaknesses.

First of all, the patient began to tell me a story which seemed to be leading up to the current complaint. I thought it best to let them tell me the story, which involved a history of work-related trauma and struggles while at work. This helped me to uncover any potential yellow and blue flags right off the bat whihc would inform any prognosis and precepitating factors of the working diagnosis.

After the story reached a logical conclusion, I interjected and asked what the patient wanted me to look at and what her expectations were from me. I thought it prudent to ask those two questions first, as time was getting on a bit, and I wanted to tackle the impending black hole of time dissolution.

I managed to get around 30 mins into the appointment and have a rough idea of several differential diagnoses. In the interests of saving time, I decided the best course of action was to pause the case history, tell the patient I would discuss the case with my tutor, which allowed me some time to gather my thoughts and process the tsumani of information that had been presented to me. I also made an arguably bold move of warning the patient that there may not be enough time for treatment, and that I would focus my efforts on finding what the cause of her symptoms were.

After having a few watertight differnential diagnoses, I went back into the room, and explained that I would ask necessary safety questions regarding the case to rule out any red flags. I then proceeded to explain that I would examine the patient and aim to get in treatment. Even though I had earlier mentioned that there would possibly be no treatment, I felt that patient would either be expecting treatment or be welcomed with the surprise of treatment.

After examining for a short time, I had concluded my working diagnosis and explianed to the patient and her husband what I was thinking, and making it interactive by referring to the symptom reproduction during testing.

I managed to get in a full supine GOT routine for the patient, running over time as I did so, however, I felt in that moment, it was warranted, due to the nature of the case and the anxiety around both the patient and her husband. Both the patient and husband left with seemingly minimal anxiety regarding the symptoms, and happy to return in the forthcoming week.

Throughout the case, a number of aspects really pushed my limits. Time-keeping was the primary, where I had not had an experience of a patient reciting a pre-thought story at the beginning of a case history since term 2 of 3rd year. I had done my best at the time, to control the room and ensure time was spent efficiently. The treatment was in-fact, the only aspect which I ran-over time.

Another aspect of my weaknesses is or, was, controlling the room, ensuring I, as a professional, was in charge of the process. The husband of the patient mentioned near the beginning of the session that he was a qualified massage therapist and a training paramedic. This probabaly would have thrown me off course and unnerved me in Year 3, however, I was unphased by this at this stage.

I found myself in a dilemma during most of the case history, in that there was a dynamic I had never come acorss before, which was that the patient wasnt a native, and husband was, who proceeded to speak on behalf of the wife, but often in an interruptive manner.

When such a situation would arise, I would ensure I kept a majority of my attention on the patient, to make sure she was: a. agreeing with the information expressed by her husband, and b. that she felt I acknowledged her as the patient and didnt dismiss her as her husband seemed to have done. In such a dynamic in the future, I feel that the approach I adopted with this case would always benefit the patient-practitioner rapport.

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For new patients:

1. Case History - minimise patient giving 'nice-to-know' over 'need-to-know' information - nice to know information can be discussed during treatment.

2. Testing - Test for the DDx, observe with scanning eyes, Be specific with palpation and with testing ROM.

3. Explaining the Dx to the patient - cut to the chase, dont repeat/ go round in circles - eating away at time.

4. Consent gaining - ensure at each stage the patient is aware of what will happen next, for individual techniques, a simple, location-risk/benefit/alternative will suffice.

5. Treatment - Feel the change, move on.

6. Treat to TIME - After giving 100%, the patient will not expect more, nor can you afford to give more, you are not expected to treat everything all at once.

7. Control - keep in control of the room the entire time to ensure the process flows smoothly - constantly ensuring that when you move onto the next stage, it is in the patients interest.

For continuing patients:

Much the same as for new patients,  including:

1. Case History - How has their function improved? Stray away from Pain-centred model. Discuss how function improvement is a sign that health is restoring. If the pt presents with new symptoms, breifly question about any new activities/ overworking the body/ changes in social surroundings.

2. Testing - test what is needed + Osteopathic tests - PRM/ function of Inter-arch pivots and keystones/ Fascial listening - BE MINDFUL OF TIME - i.e. stick to listening posts.

3. Consent gaining - No need for an extensive spiel as in the first consultation - but remind the patient of location prior to technique.

4. Treatment - Feel the change, move on.

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Yr 1 Physical Evaluation Assessment (1/3)

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Yr 1 Physical Evaluation Assessment (1/3)

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Yr 1 Physical Evaluation Assessment (2/3)

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Yr 1 Physical Evaluation Assessment (2/3)

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Yr 1 Physical Evaluation Assessment (3/3)

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Yr 1 Physical Evaluation Assessment (3/3)

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Year 2 Physical evaluation assessment 1/2

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Year 2 Physical evaluation assessment 1/2

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Year 2 Physical evaluation assessment 2/2

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Year 2 Physical evaluation assessment 2/2

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Year 2 General Medical Screening assessment (1) 1/2

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Year 2 General Medical Screening assessment (1) 1/2

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Year 2 General Medical Screening assessment (1) 2/2

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Year 2 General Medical Screening assessment (1) 2/2

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Year 2 General Medical Screening assessment (2) 1/2

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Year 2 General Medical Screening assessment (2) 1/2

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Year 2 General Medical Screening assessment (2) 2/2

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Year 2 General Medical Screening assessment (2) 2/2

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Year 2 General Medical Screening assessment (3)

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Year 2 General Medical Screening assessment (3)

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Year 2 Physiology essay marks and feedback

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Year 2 Physiology essay marks and feedback

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As mentioned in a previous post about the depth of palpation I was unaware that was hidden from me until discovering with Gez Lamb, I found myself recently applying this newly-found palpation in practice, and having great results.

The patient (female, 44 and short slender build) was coming in with hypersensitivity of the entire left upper and lower limb, with burning pain down her left lateral thigh, onset was after heavy lifting at work in a warehouse.

I had perfromed all necessary tests in the intitial consultation and reassessed in the second appointment, but that time, had decided to practice palpation of her tissue fileds. Interestingly, her body didnt seem to express a fluid field at all. I ensued to perfom cranial with her, where I discussed the advice of taking in water after the session. This is where it would transpire that the patient has a fear of water due to a couple of historical epsiodes where she nearly drowned.

This finding of no fluid field, alongside the knowledge of her fear made me concerend that perhaps she was dehydrated, if not slightly, then quite significantly. I spent a significant amount of time in the second session relating her fear to a possibility for her prognosis to be worse unless she found a way to start drinking a lot more water.

I was out of my comfort zone, but I revelled in it, I was showing humanity and finding a solution to a problem.

Incredibly, in the third session, the patient had noted she had started drinking around a litre of water a day since the last session, and her symptoms had dramatically improved, with better quality sleep, reduced burning sensations, less lower back pain, reduced hypersensitivity and a happier demeanour.

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Learning Action Plan term 2 Children's Clinic

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Learning Action Plan term 2 Children's Clinic