https://padlet.com/rosamundheath/lhgop37e4ohu Made with good vibes en-us 2018-05-22 19:46:49 UTC 2026-02-27 13:40:29 UTC hello@padlet.com rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/262829991 I originally posted this to see how easy it would be to upload coursework to the padlet as part of the reflective process.  I didn't really reflect on the exam initially, however I have written about this below.  I have also realised that uploading coursework to the padlet is a little slow and cumbersome but it will make assessing the portfolio much easier for my assessor, so from that point of view it is very useful having an online tool we can implement.
What I have learnt from the exams this year and what I can do to improve my knowledge (B2, B3, B4)
I find practical exams really hard.  No matter how much I revise, I still don't seem to get a good mark.  I get really nervous, and I was pleasantly surprised with the mark I received on the sheet below.  I didn't do as well on the subsequent exams.  I find I need to use these techniques in clinic on real patients (B2, B3, B4) who need these techniques performed, as it is much harder knowing whether you have been effective on fellow students, and if it is not relevant for me, my brain struggles to remember the technique.  Recently however, I was able to use an MET technique on a patient that clearly resonated with me; I had not had time to practise it but I had managed to visualise it when we learned it and I used it successfully.  It is has taken a long time for me for all the permutations of anatomy to be utilised in a practical way; I am finally beginning to be able to use techniques and occasionally improvise when I fully understand how the muscle's actions work.  We were taught anatomy in a very dry fashion over the first two years of the course, which I think did not really go in to my brain very well, so I have had to find ways to understand the anatomy and make it come to life in a 3D.  By doing more anatomy/prosection days (B2, B3, B4), like the one I went to in January is definitely the way forward for me.  Each time I do this, a little more sticks and I build on a firm base (see below).  I have also booked two more of these courses because it had such a profound effect on me (and I don't usually like getting up at 6 am on a saturday morning).]]> 2018-05-22 19:47:15 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/262829991 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/263097870 Clinic 23 may 2018
Reflective practice  - realised GOT is as effective as BMT for my patient today. I need to revise PMR.]]> 2018-05-23 16:53:09 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/263097870 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/263142969  
I have revised my knowledge of PMR as I realised it needs frequent refreshment.]]> 2018-05-23 18:57:51 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/263142969 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/270307983 I revised the bony landmarks of the scapula to improve my knowledge of where all the 17 muscles of the shoulder attach to the scapula.]]> 2018-07-16 13:28:53 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/270307983 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/273435006 There are many different medications on the market, however one that is frequently in use for many patients is omeprazole.  I have learned more about this medication so that I am better informed.  It is not a very nice drug: it inhibits gastric acids and means that calcium, magnesium and vitamin B12 are not absorbed by the body (A3, A5, A6, B2, B3, B4, C3, C5, C7, D1). Not good.  However for many of these patients it gives them relief.  It is important though to understand the mechanism of these medications so that I can help my patients make an informed choice.  However, omeprazole  has also been shown to offer protection to the small intestine against gastric and duodenal ulcers in those people taking high quantities of NSAIDs (A3, A5, B2, B3, B4, C3, C5, C7, D1) It may also protect the small intestine from damage induced by the use of indomethacin. This may work by the anti-inflammatory and anti-oxidant properties of this medication. It may be that this is a benefit that can be utilised for people with iintestinal inflammatory diseases (A3, A5, A6, B2, B3, B4, C3, C5, C7, C8).Omeprazole works by reducing the production of acid by the stomach; by irreversibly blocking an enzyme called H+/K+ ATPase which controls acid production. This enzyme is also known as the proton pump and is found in the parietal cells of the stomach wall. ]]> 2018-08-16 08:49:38 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/273435006 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/273436440 https://www.medscape.com/viewarticle/760191

]]> 2018-08-16 09:02:20 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/273436440 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/274892585 Increasing my learning; follow up from the previous post (B2, B3, B4)]]> 2018-08-23 15:15:23 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/274892585 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/274895501 What happened?
I had a patient who had MS.  I was challenged by my tutor to look up the ccomplications of Multiple Sclerosis (B2, B3, B4).
She also suffers from asthma; and has a cough that doesn't go away.  I realised that I didn't understand the link between multiple sclerosis, so I thought it would be good for my learning and knowledge to learn more about how multiple sclerosis sufferers suffer from asthma, and what it does to the lungs. (C3, C5, C7, D1, D14 ) 
What did I gain from this? This improved my knowledge of this condition and showed me how important it is to be inquisitive about my patients' conditions.  This link showed me that it is as important to address the underlying problems, not just the 'superficial' problem on top; as I had no idea how the MS would affect the patient's lungs (although if I had thought more carefully, it is fairly obvious) that lung function would be affected due to the demyelination of the nerves which occurs in MS. Although I attempted to treat the diaphragm and the sternum with some success, I think I might have had more success if I could have got the patient 'more on board' to come for more regular treatment, rather than once a month. (A3, A5, A6, B2, B3, B4, C3, C5, C7, D1) However, although I used techniques which involved the IVM; I think now I would use techniques which mobilised the tissues more, to shift any build up of fluid on the lungs and encourage nutrition, drainage and waste removal. She brushes off the asthma (which is underlying rather than a big factor in her life) as 'less important' and I think as I reflect on this patient, my inexperience as I took over her treatment just before the beginning of summer clinic, begins to me to feel more relevant with this patient.  What would I do differently now?  I would try to get her really engaged with the treatment process (which I know has helped her) in an active way rather than a passive way (A3, A5, A6).  It is difficult to know whether someone can only afford one treatment per month, or whether they think that is all that necessary; there is the moral dilemma of how far you go to convince the patient that you can help them more if they visit you more frequently.]]> 2018-08-23 15:22:26 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/274895501 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295081551 20 October 2018
I had a patient who told me he had pain which was in the ulnar border area; I thought I should revise the difference between an ulnar nerve neuropathy and a T1 radiculopathy to make it easier to diagnose this.  In fact, I had already had some feedback in year 3 that I should revise the ulnar nerve, so I was a little late doing this, however this patient and this revision helped my knoweldge.
As you will see below, I did quite a lot to increase my knowledge.]]> 2018-10-20 14:27:21 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295081551 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295081809 20 October 2018]]> 2018-10-20 14:30:12 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295081809 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295082204 2018-10-20 14:33:54 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295082204 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295082828 Tedious but necessary (that is what I wrote on 20/10/2018)   22 March 2019.  (D1, D2, D3, D4) Interestingly, the more I reflect, the easier it becomes and it becomes easier to treat my patients as I understand their conditions better.  I am becoming more reflective, although increasingly tired, I find it very helpful to review my patients' cases and see how I can improve my treatment for next time.  I am understanding the process better and I think it is becoming interesting, rather than tedious.  I wish there were more hours in the day so I have more time to reflect on how I have done with my patients.
https://www.brookes.ac.uk/students/upgrade/study-skills/reflective-writing-gibbs/
10 April 2019
I am finding it easier to reflect on patients and how I have been with them, especially when I give myself time and space to reflect on the process. (D1, D2, D3, D4)  Sometimes it helps having someone to listen to what I am saying, although I think I can also 'pretend' to have someone listening, as that also gives me an outlet as though there were someone listening to me. I think it is also hard finding the time to write reflective pieces all the time, I frequently reflect on my performance in clinic, good and bad, but sometimes I am in the car and don't have the ability to record what I am thinking or saying.]]> 2018-10-20 14:40:17 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295082828 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295084030 Ulnar nerve neuropathy]]> 2018-10-20 14:52:47 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/295084030 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299917017 How can I best help my patient with spinal stenosis?]]> 2018-11-02 17:39:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299917017 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299917792 Signs and symptoms]]> 2018-11-02 17:41:16 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299917792 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299919721 2018-11-02 17:44:31 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/299919721 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300006481 2018-11-02 22:16:21 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300006481 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300007108 2018-11-02 22:22:56 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300007108 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300007156 2018-11-02 22:23:30 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300007156 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300008635 2018-11-02 22:38:40 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/300008635 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/319723661 I need to improve my knowledge of medications.]]> 2019-01-11 15:48:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/319723661 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323953896 My patient came to the Clinic today after being let down by the Osteopath at the YMCA. Networking does work, a friend of her's recommended she come to the Clinic, when the YMCA muddled up her time, she phoned the Clinic and made an appointment!]]> 2019-01-24 15:17:13 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323953896 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323958584 I had a patient who had various auto immune disorders, including thyroid dysfunction.
I looked up the significance of this and realised that there is a connection between thyroid dysfunction and vitiligo. This has increased my understanding of auto-immune disease.]]> 2019-01-24 15:23:52 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323958584 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323963907 Migraine - with and without aura]]> 2019-01-24 15:31:33 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323963907 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323964268 This was discussed in the team room and I decided to investigate this further (B2, B3, B4, C7) 
Bladder Pain syndrome
Chronic bladder health issue
 - pain and pressure in the bladder area
symptoms:
lasting more than six weeks - without having an infection or other clear causes
Age: 30s and 40s
Women > men
Conventional treatment:
NSAIDs and naproxen
tricyclic antidepressants eg amitriptyline or imipramine
antihistamines eg loratadine
Potassium sensitivity test may help to diagnose interstitial cystitis.

]]> 2019-01-24 15:32:12 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/323964268 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324160895 2019-01-24 21:29:57 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324160895 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324652787 I looked up the link between hypo/hyper thyroidism to understand the link between adhesive capsulitis and auto-immune dysfunction.  This has increased my understanding of this and other similar dysfunctions (B2, B3, B4)]]> 2019-01-27 10:02:30 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324652787 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324653022 Auto-immune diseases.]]> 2019-01-27 10:05:25 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324653022 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324653960 Recently I have had quite a few patients with interesting pathology! My understanding of PMR (B2, B3, B4) is greater and I understand now how an underlying systemic disease can create 'better' conditions for things such as adhesive capsulitis to occur.]]> 2019-01-27 10:15:24 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324653960 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654239 2019-01-27 10:18:25 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654239 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654299 2019-01-27 10:18:55 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654299 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654621 2019-01-27 10:21:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/324654621 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325149889 2019-01-28 20:42:04 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325149889 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325191486 My patient's liver needs detoxification. I looked up suitable herbs that could help him.]]> 2019-01-28 23:31:17 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325191486 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325192642 2019-01-28 23:39:54 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325192642 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325823311 I have been looking up more about psoriatic arthritis, as I have a patient tomorrow who has it.  Best to be more informed, so I know what questions to ask her (B2, B3, B4)]]> 2019-01-30 13:43:54 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325823311 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325824887 something that patients with psoriatic arthritis may develop (B2, B3, B4)

]]> 2019-01-30 13:47:51 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325824887 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325827976 (28 jan)
What happened?
My patient had had a headache since the previous wednesday. My tutor proceded to ask me about nerve entrapment for the headache - was it root or peripheral entrapment.  I did eventually come up with greater occipital (peripheral nerve) due to the location of the area of pain (sub-occiptal muscles) but I realised that I need to do more revision of this area.]]> 2019-01-30 13:55:37 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325827976 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325874249 What did I learn?
what is it?
An auto-immune disorder, it affects men and women equally.
I have two patients with it, so I thought really I should know more about the condition.
It can affect any area of the body although different types of psoriasis tend to occur on different areas of the body.
There is a link with coeliac disease; these people tend to have a genetic component with the HLA-B27 marker frequently present.]]> 2019-01-30 15:23:32 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325874249 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325883150 For decades, HLA-C*06 has been accepted as the main descriptor of the two main phenotypes of skin psoriasis. There is now compelling evidence to suggest that HLA-C*06 is only a genetic biomarker for skin involvement and not for joint involvement in psoriatic disease. (B2, B3, B4)]]> 2019-01-30 15:38:39 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325883150 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325885968 What did I learn? Well it would seem there may be a link, but it may be more that people with psoriasis are sensitive to gluten rather than allergic.  I have a patient who has endometriosis and had been suffering with IBS symptoms for a long time.  I suggested to her that it might be worth trying to cut out products with gluten in them, and see if she noticed an improvement. I was impressed because she actually did what I suggested, and cut out gluten products. The change was phenomenal, she has had no more IBS symptoms since and she is very happy with the result. I also suggested to her that she try drinking peppermint tea for relaxing herself and her gut, this was also another success. Wow. It is difficult to know whether patients will take up your suggestion, but this one has noticed a significant improvemnt in her health and wellbeing by taking up my suggestions, so I shall certainly suggest these ideas to patients in the future, when it is appropriate. This was very definitely shared decision making.

]]> 2019-01-30 15:43:44 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/325885968 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/326377966 I felt today that some major revision of TOS is required as I have had a few patients recently who have presented with TOS like symptoms (B2, B3, B4).

]]> 2019-01-31 17:25:26 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/326377966 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/329246701 One of my patients suffers with this so I thought I should look up the medication associated with it and the symptoms too.]]> 2019-02-08 15:34:45 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/329246701 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/332468982 Today I had a patient with ankylosing spondylitis (B2, B3, B4). I have been having hypnotherapy to try to be more calm in the room and I certainly didn't feel like the usual blank screen had entered my head.

]]> 2019-02-18 21:45:32 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/332468982 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/334167122 I have been learning more about plagiocephaly and brachiocephaly as well as the more serious craniosynostosis (B2, B3, B4, C3, C5, C7, C8)

]]> 2019-02-22 15:14:01 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/334167122 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/334173320 It is important to know about this condition as this is a red flag, as we are trained to treat all ages and I am especially interested in treatment of babies (B2, B3, B4, C9, D1).]]> 2019-02-22 15:24:23 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/334173320 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336532403 adductor tubercle
I palpated this tubercle on my patient today and realised that that is what it was!  I was fairly confident that the adductor magnus inserted into it, but thought I should do my homework later and check (B2, B3, B4, C3, C7)
Well I was right, but I was also able to confirm the innervation, which was the obturator nerve, whose nerve roots are the L3, L4, where my patient's back pain starts.  Is this co-incidence or is her pain to do with the surgery for her meniscus and recently diagnosed OA of her right knee?
I find it very helpful looking at pictures of the adductor magnus as well as observing pictures for adductor longus and brevis and seeing how/where they attach onto the pubic symphysis. ]]> 2019-02-28 17:41:22 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336532403 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336535336 Anatomy of the adductor tubercle]]> 2019-02-28 17:46:26 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336535336 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336535615 Oh yes, allows the passage of the femoral vessels.  this makes even more sense now. (B2, B3, B4)]]> 2019-02-28 17:46:59 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336535615 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336537498 2019-02-28 17:50:20 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/336537498 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337129617 2019-03-02 16:00:48 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337129617 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337130942 What questions should I ask if my patient says they bruise easily?
I decided to investigate more fully and reflect on the fact that for a whole year and a half in clinic I have allowed myself to be ignorant of the answers (B2, B3, B4).  However now I know and am now more knowledgeable and safer in clinic as a result.  I love learning more too I should have looked up the question at the beginning of Year 3 but at least now is better than never.]]> 2019-03-02 16:11:17 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337130942 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337138960 The patient which will come in for my returning patient part of the exam had her gall bladder removed. In order to be better informed about the process and the possible complications, I decided I should look up this procedure to make sure I can support my patient in caring for herself and any future patients who have gallbladder surgery.

]]> 2019-03-02 17:33:34 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/337138960 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338932136 2019-03-07 16:10:19 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338932136 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338937747 A lot of the 'D' Osteopathic Practice Standards were difficult to write about initially; I wasn't sure how many of them I would meet through patients; so I decided that it would be easier to write about these as individual pieces; as I wrote about them I was able to see how I had actually met these standards, without actually realising I had met them!  It was good to reflect on the process of how I had met these standards, almost incidentally, by being who I am, by being polite, caring and aware of issues such as health and safety, as well as the need to clean my hands between patients.
.

]]> 2019-03-07 16:18:28 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338937747 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338939323 I love using 'cranial' techniques: I am good at this and it helps improve my patients health.  However I have realised it is not always easy to explain to my patients what I am doing or why I am doing it (C7, D4).  This article has helped increase my knowledge of BLT and BMT.  It is essential so that I can share the decision making process with them and enable them to give me full consent.]]> 2019-03-07 16:20:46 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338939323 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338942044 Ensure that your patient records are full, accurate and completed promptly.
Today I was again pulled up for inaccurate wording in my notes. I am trying harder to make sure I describe muscles accurately, if they are hyper contracted, or hyper tonic, or even hyper mobile. I will be hyper vigilant to make sure I don't do this again.]]> 2019-03-07 16:24:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/338942044 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/339493865 How I have achieved these standards.]]> 2019-03-08 22:06:09 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/339493865 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/339661566 I have revised the procedure for knee arthroscopy/meniscus repair. I understand this procedure much better now; it has increased my knowledge and how I should advise future patients who have this procedure t]]> 2019-03-10 11:44:32 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/339661566 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340180130 2019-03-11 21:45:40 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340180130 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340573122 https://www.ted.com/talks/tom_thum_and_matthew_broadhurst_what_a_beatboxer_s_vocal_cords_look_like_in_action?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare]]> 2019-03-12 18:25:16 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340573122 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340612617 2019-03-12 19:51:27 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340612617 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340617088 https://pin.it/zpk6pm4rbzjdwm]]> 2019-03-12 20:03:27 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/340617088 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/341371599 2019-03-14 15:07:31 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/341371599 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/341378983 2019-03-14 15:19:04 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/341378983 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344283755 2019-03-22 16:03:09 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344283755 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344286460 2019-03-22 16:09:13 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344286460 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344292002 2019-03-22 16:21:10 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344292002 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344315458 2019-03-22 17:15:14 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344315458 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344324971 I had a patient in the summer clinic with cervical spondylosis; my tutor told me to look this up as I wasn't completely sure of demographics etc (B2, B3, B4,, C3, C7)]]> 2019-03-22 17:31:15 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344324971 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344326705 I actually wrote this in 2018.  It is clear to me that I need to keep on revising this condition so I can help my patients more, as the more I understand it, the quicker my patients will get better (B2, B3, B4, C3, C5, C7)]]> 2019-03-22 17:34:21 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344326705 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344340964 A short piece I wrote about meeting D2]]> 2019-03-22 18:06:33 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344340964 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344341364 2019-03-22 18:07:20 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344341364 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344342570 2019-03-22 18:10:00 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344342570 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344342794 2019-03-22 18:10:31 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344342794 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344343000 2019-03-22 18:10:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344343000 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344343205 2019-03-22 18:11:29 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344343205 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344350022 2019-03-22 18:26:14 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344350022 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344370547 I have recently been revising the questions for Benign Prostatic Hyperplasia (B2, B3, B4, C1, C2, C3, C5, C7,  C8

]]> 2019-03-22 19:34:16 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344370547 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344373970 2019-03-22 19:48:53 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344373970 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344375668 2019-03-22 19:56:20 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344375668 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344472369 2019-03-23 16:42:22 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344472369 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344537062 see the word document below]]> 2019-03-24 09:41:28 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344537062 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344537153 I had a patient present with cervical spondylosis; however my tutor pushed me to question whether it could be a cervical myelopathy. So I realised that I needed to refresh my memory of a cervical myelopathy. What have I learned? How I can distinguish these condiitons and recognise the difference in future patients; it has made me safe because I can recognise the different symptoms of these conditions and I will know when I can help a patient and when the condition is beyond my expertise.]]> 2019-03-24 09:42:38 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344537153 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344538458 picture of psoriasis (B2, B3, B4)]]> 2019-03-24 09:59:49 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344538458 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344538604 Psoriatic disease.  I was very interested by this disease.  
What happened? A whole family, one by one, came to see me in clinic and I have seen first hand the different symptoms they have. What did I learn? How this disease affects peoples lives; it makes their skin very itchy and they tend to be inflamed and on quite nasty medications to reduce the symptoms of this disease.  In fact although the grandmother of the family doesn't have psoriatic arthritis, she has nodular prurigo and is currently using methotrexate to calm the symptoms. She knows that methotrexate has very nasty side effects but it makes her life considerably easier and less painful. I think I will find it quite easy to spot people with these diseases now, so this is what I have taken away from this experience.  I am beginning to become more 'investigative' (B2, B3, B4, C3, C7, D1) and see links with other inflammatory conditions.
What can I do for this patient of mine? I can support her in her decisions, and try to educate her so that she knows and understands the damage she does when she scratches her legs, which she does frequently.  She is also beginning to understand the consequences of eating food that been defrosted and sits around, 'growing' histamines which then make her legs hot, inflamed and itchy (C3, C7,  C8, A5). A truly horrible condition, but I am sure this is another auto-immune condition at least partially brought on because of stressful events in her life, some of which she has told me about. 
What next? Since I have started seeing this patient, I have recently spoken to Howard Beardmore of the British Institute of Osteopathy about my mother's eczema (and I am thinking about doing his postgraduate course (B2, B3, B4) and I am going to investigate to see whether this patient's pelvis feels 'congested' as the nodular prurigo is on the L4/L5 dermatome, more so on the left leg than the right (C3, C5, C7, C8)]]> 2019-03-24 10:01:38 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344538604 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344539157 picture of psoriasis (B2, B3, B4)]]> 2019-03-24 10:08:13 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344539157 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344593364 I decided to revisit the anatomy of the larynx (B2, B3, B4) due to its pertinence to my own personal experience.]]> 2019-03-24 18:46:13 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/344593364 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345449948 I felt very disappointed after I received the results for this exam. Was I really this bad? Well I think they were fair with their assessment although I think a little of it is down to exam technique, which is something I am not good at, especially for practical exams. I have been investigating the things I fell down on such as the lack of reasoning as to why QL was in dysfunction.]]> 2019-03-26 20:06:34 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345449948 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345451882 2019-03-26 20:13:18 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345451882 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345454688 I have reviewed the feedback from my CCA1 and have done digging into where / what I did wrong, not well enough etc.
By understanding the role that QL plays, I can better explain to the examiners what is happening to the patient's body and why. I have gone back to basics and checked the origins and insertions as well as nerve and action of this muscle. Although I knew this muscle's origins and insertions, I did not tell the examiners all I knew and maybe I had not quite processed its action on side bending of the spine. Well I definitely know now.]]> 2019-03-26 20:23:35 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345454688 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345458856 Learning more about the QL and how it attaches, this was important to understand and process the actions of QL. I hadn't appreciated what makes the spine side bend. However, now I have definitely learned from my mistakes and will be able to apply this better in future.]]> 2019-03-26 20:37:51 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345458856 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345460131 And its role in relationship to QL. I didn't understand the role of the iliolumbar ligament in relationship to the QL muscle, now however, I have researched it and my understanding of the lumbar spine and pelvis has improved by looking up this ligament and its involvement with the QL. It will be more in my fore thoughts when i am investigating back pain.]]> 2019-03-26 20:42:33 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345460131 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345462035 2019-03-26 20:49:45 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345462035 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345462572 What hapened? CCA1 exam.
I failed to understand the implications of QL hypercontracture and possibly the involvement of the Ilio llumbar ligament as well.  
What did i do next?
The ilio lumbar ligament has both horizontal and diagonal properties which enables it to stabilise both side bending and rotational movements.  Now, i have thoroughly investigated and I am better informed too.  Dysfunctions of this ligament contribute to lower back pain.
This better understanding of this ligament will allow me to have a greater understanding of low back pain when a patient rotates or side bends.]]> 2019-03-26 20:51:37 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345462572 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345465740 Definitely not my best performance and a lot of room for improvement. This is the feedback from the new patient experience; I will be getting feedback from the examiners so that I can move forward in a positive way.]]> 2019-03-26 21:03:35 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/345465740 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/350403841 2019-04-10 15:24:41 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/350403841 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/351383663 What happened?
I had two new patients with psoriatic arthritis in quick succession; it made me look at the link with coeliac disease as well as the blood markers for psoriasis (B2, B3, B4).
Why did I do this?
Well I knew my knowledge about psoriasis was poor and I wondered about various links with other illnesses. I was also curious about the link with other auto-immune diseases (B2, B3) such as coeliac disease.
What improved? My knowledge about psoriasis (B2, B3, B4). This will help me direct patients in future, if they are at the early stage of diagnosis, or if they haven't got a diagnosis I will be able to give them information about their disease (C3, C5, C7, C8).]]> 2019-04-13 15:23:20 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/351383663 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352336645 I decided to make the most of my car journeys and subscribe to the podcasts made available by Robert Whitaker, the creator of Instant Anatomy (B2, B3, B4).  I met Robert at the COG prosection/anatomy day in January and he was as inspiring as his book is.]]> 2019-04-17 15:54:34 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352336645 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352339304 Initially I wanted to study midwifery, however, when it came to being interviewed, I was rejected and I had to choose something else to study. I wasn't going to let a year of study go wasted or lose interest in obtaining good grades because I had been rejected. I was determined to get the grades I needed for midwifery even I had been rejected. This way I kept up my motivation (B2, B3, B4). Soon after I was interviewed at the ESO and I needed a lot fewer distinctions than those needed for midwifery. Luckily my sense of determination comes into play at these times and I wanted to do well. It mattered to me and wanted to show everyone I knew that I had done well too.]]> 2019-04-17 16:01:58 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352339304 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352339517 2019-04-17 16:02:39 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352339517 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352567771 I have recognised the need for empathy at the highest level here (C1, C2, C3, C4, C5, C6, C7, C8, D1, D4, D6, D7, D14, D17).  There is an issue of sensitivity here that needs to be met at both clinical and ethical levels.  I can help, through talking to the patient's mother (and treatment too, if she is open to that) and I can help remove the restrictions in the baby that are causing the problems; however with this patient the problem lies deeper within the mother and what happened before this baby was conceived, and how her body responded to the stressful event and the new, exciting but still stressful event afterwards.  These issues need to be reconciled with the mother in order to help her baby; (A1, A2, A3, A4, A5, A6, B1, B2, B3, B4) however I think we can do a lot to reduce the problems that the mother is dealing with and allow her to come to terms with her grief and possible guilt at becoming pregnant so quickly.  (A1, A2, A3, A4, A5, A6, B1, B2, B3, B4, C1, C2, C3, C4, C5, C6, C7, C8, D1, D2, D3, D6, D8, D14, D17)]]> 2019-04-18 14:28:25 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352567771 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352650519 I have recently been revising the questions for Benign Prostatic Hyperplasia (B2, B3, B4, C1, C2, C3, C5, C7,  C8

]]> 2019-04-18 19:02:57 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352650519 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352662483 2019-04-18 19:50:27 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352662483 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352663163 2019-04-18 19:53:50 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/352663163 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355333968 This was an amazing introduction for my return to academic study after many years (B2, B3) . I was inspired and challenged by what I was learning and so very interested too. I was lucky: we had great tutors on the course; they inspired and interested me; enabling me to learn better. We were taught in a variety of ways too to ensure that all types of learners were catered for. It was extremely hard and it became obvious to me that to get the distinctions required you had to go above and beyond what was required of the coursework to get the best marks. The course helped 'invigorate' me after many years of being at home, bringing up my three children. Suddenly I had a purpose, structure and direction in my life again (B2, B3). My friends noticed it too, I was more 'lively' and engaged with life and the people around me. In fact I hadn't really noticed that I had dropped into a less engaged state, however, the change in me was quite obvious once I thought about it. I was faced with a challenge and I was determined to succeed. I was surrounded at college by some lovely people, there were quite a few people who dropped out of the course so I benefitted from this, as it meant we had a small group that remained. I also realised that I was probably one of the cleverest people in the class as not many people had English or Maths GCSEs! This helped me, seeing my ability first hand (B2, B3).]]> 2019-04-30 08:19:56 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355333968 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355339801 What happened?
I was so nervous.  I was convinced I had failed this exam although I just passed, with 50%.(B2, B3, B4)  I realised that I had to go to Early Morning Practice, to make sure I improved.  This, I realised, was the only way I would manage to get enough practice in during the week. However, being tired and short of sleep did not help and I found practical exams very stressful. I look back on these exams and realise that the signs of a possible auditory processing disorder were there, I would mishear what was asked of me in the exam, exam nerves are bound to make a condition like this worse, however I just assumed that it was nerves and nothing else, but these days I am so aware that I mishear questions in exam conditions that I suspect there is an auditory processing problem. ]]> 2019-04-30 08:44:43 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355339801 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355339984 2019-04-30 08:45:38 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355339984 rosamundheath https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355342222 Finally I passed everything required to make progression to year 3.  I was so relieved that I had made it to year 3.  It did not feel easy making the progression but I was happy to have passed. This was the result for my resit Technique exam.]]> 2019-04-30 08:54:53 UTC https://padlet.com/rosamundheath/lhgop37e4ohu/wish/355342222