Osteopathic Medicine

I thought I'd take advantage of my newfound free time (more on that soon) to look back on my last rotation.

Last month, I was on my Osteopathic Manipulative Medicine (OMM) rotation. Three weeks were spent in the clinic and one week in the hospital. I think this a perfect opportunity to expound upon the DO difference, since it seems to be a poorly understood difference in general.

DOs, or Doctors of Osteopathy, are fully licensed physicians with the same rights and responsibilities as MDs. DOs can be board certified in any field of medicine. They can diagnose, prescribe, and treat any illness. Education at osteopathic medical schools is very comparable to education at MD schools.

DOs are unique, though, in their history, philosophy, culture, and treatment. Osteopathy was founded by Andrew Taylor Still, an MD, in the late 1800s. He was frustrated by medical practice because, at the time, much of the work doctors did actually caused more harm than good. He did extensive study of the human body and developed a set of principles that have become the bedrock of osteopathic medicine.

1. The body is an integrated unit of mind, body, and spirit
2. The body possesses self-regulatory mechanisms, having the inherent capacity to defend, repair, and remodel itself.
3. Structure and function are reciprocally inter-related.
4. Rational therapy is based on consideration of the first three principles.

 Dr. Still contended that if there is a problem with the body structurally, it can impede the body functionally, both at the site of the problem, and sometimes elsewhere. The body's structural problem, what DOs call "somatic dysfunction," can also impinge upon the body's natural ability to heal itself.

This is where OMM comes into the picture. OMM is a hands-on approach that DOs use to diagnose and treat somatic dysfunction. DOs use OMM to restore structure and function to the body, helping the body to heal itself, restoring motion, and decreasing pain.

Students at Osteopathic medical schools have extra classes and labs every semester during the first two years of medical school to learn these hands-on diagnostic and treatment skills.  We are trained to identify somatic dysfunction based on assymmetry, restriction of motion, and tissue texture changes. We can then often treat these problems using manipulative medicine. OMM can be used for anything from musculoskeletal pain (i.e. back, neck, knee pain) to headaches to ear infections to asthma.

The mind, body, spirit connection is another important hallmark of osteopathic medicine. DOs are holistic in their approach, striving to always see the patient as a whole person, never just a sum of symptoms. DOs are prepared and able to go into any medical specialty, but osteopathic medical education is great about stressing the importance of and, ultimately, providing a lot of physicians for primary care, especially in rural and underserved areas, which I think is awesome too.

When Aaron and I were applying for medical school, we got in at both M.D. and D.O. schools. We wanted to go DO, though, because we liked osteopathic philosophy, wanted to learn OMM, and felt it was a good fit culture-wise for us. We have been so pleased with decision and feel we've gotten a wonderful education. We love the whole person, compassionate approach that is emphasized in our training. We love bringing healing by laying on hands. The power of touch to heal is powerful. We still learn to prescribe medication, use lab values and imaging, etc. as any MD would, but we feel so grateful to have the extra tool of OMM at our disposal, especially for treating pain and other neuromusculoskeletal complaints.

Anyhow, I've used OMM on many of my rotations, but last month was a month totally dedicated to perfecting the skills we'd learned our first couple years of medical school. I really loved having a lot of time to spend with each patient; it was great having lots of time to talk and get to know the patients as I worked on their back, neck, etc. The feeling of taking away someone's pain, sometimes after years of suffering, is one of the best feelings. There were some tears of joy shed this past month in the clinic, which isn't something you get to see too often in medicine.

In the hospital, I was often the bright spot in the patients' day, so it was fun to feel like a heroine ;-) Most of the other medical personnel coming in and out of the patients' room had to bring them bad news about their need to repeat a colonoscopy due to a poor colon prep or stick them with another needle for yet another blood draw... but I got to just be the girl who came in and helped them breathe more easily and rest more comfortably :-) I got to have some great conversations and pray with some patients, and I saw, more than ever, the power of hands in communication and in healing.

So, all in all, it was a great month. Hooray for osteopathy!

(And no, I did not take the above photo specifically for this blog - the photo is 2 years old and was taken for something else. I don't blame you, though, if you thought I did take a fake OMM picture of me and Aaron... I am pretty nerdy like that ;-) )

Julia's Philbrook Adventure

We took Julia to the Philbrook Museum of Art in January for one of their free family Saturdays. Just for signing up, Julia got her very own art kit, complete with a pad of paper, a pencil, and an eraser, and a promise for more art supplies if we bring her back. Hilarious possessions for a then thirteen-month-old, I know. We only let her "write" with the pencil under tight supervision, lest she poke her eye out.

I really love that museums, libraries, etc. are such good sports about parents signing up their much-too-young children for such things, because they have the foresight to know that children grow and that it's better early than late for getting children interested in art, reading, etc. I mean, Julia couldn't even scribble at the time, let alone participate in the clay sculpture making going on there that weekend, but even a couple months later, I think she'd have a lot of fun at one of their events, and certainly will by the time she's even older.  Hooray for beautiful art and beautiful gardens and family friendly (free!) events!

Julia loves "Jee Jee"

Julia loves "May May"

Deep in contemplation.

January 2012 Photos

Here's a smattering of random January photos. Enjoy!

Artist in bloom.

Spaghetti-sauce-faced and -handed baby gets transported to the bath by daddy, who didn't want to get red sauce stains on his shirt.

Julia, enjoying her birthday/Christmas celebration with Alex :-)

Not the kind of group you'd really expect to be playing a fantasy medieval adventure co-op board game, eh?

Birthday girl = Mr. X

Julia with her "best friend," Violet, the singing dog.

Someone's pretty excited about a Sesame Street youtube music video clip.

Early Winter Photos - 2011

I tend to get super behind in posting photos, so enjoy this delayed deluge of photos from November and December!  It's amazing to me how much smaller Julia already looks to me in these pictures from only a few months ago!

My library fine receipt from a trip to the library in November. Amazingly, we only owed $17.65!

Julia's green male friends - Shrek and the Hulk.  They were her main squeezes once upon a time.

Rocking her new shoes!

Sillies.

Julia used to LOVE this old purple lunch box. Sarah used it in elementary school, I used it in medical school, and we used it to tote Julia's milk and food. She always wanted to hold it on the way to and from my parents' house, and she used to freak out if I broke her grip to put her in her carseat.

These last few photos are from the last day of 2011!  What a beautiful year it was!

Awkward family photo

JGI ver 1.25

I had a powerpoint presentation to work on the other day, so naturally, I felt it was the perfect time to work on writing up....

Julia's 15 month post!

Procrastinators of the world, unite! 

Can you believe that Julia is 1 1/4 years old??  Neither can I!  Time is flying like crazy.

• Julia likes to feed her milk, water, and play food to her baby doll, stuffed animals, finger puppets, book characters, etc.  She loves sharing and she's very nurturing. 
• She has taken a huge interest in letters.  She can sing along decently well to the alphabet song and can spell her name aloud when asked, usually without prompting.  We have foam letters and numbers in the bathtub that we enjoy practicing with her.  
• Her ability to sing words to songs is increasing. She's especially good at knowing some of the words to the songs that her singing stuffed dog, Violet, performs.
• Julia is getting really good at coloring. We draw outlines for her in chalk or crayon, and she focuses her efforts on scribbling on what we've drawn. She can't stay in the lines, but she definitely centers around what she's trying to color in. She asks to color several times a day by making a scribbling motion with her hand and saying, "Write!"
• Our baby is still an outdoors lady. She runs to the door many, many, many, many, many times a day, saying, "Outside!" Actually, that's what she used to do. Lately, she says "outsideoutsideoutsideoutsideoutside..." very quickly and under her breath. It sounds like a crazy chant uttered by someone under house arrest driven mad by cabin fever. Once outside, she runs around, picking up leaves and rocks, digging in the dirt with her fingers, trying to eat said dirt, and chasing birds with great enthusiasm.
• I gave Julia her first real hair cut the other day. We put a towel around her and Aaron held her against him with her arms pinned down to her sides. I stabilized her head with one hand and cut her bangs with the other. I had fun making her look less wild. She hated it, but she probably enjoys not having hair in her eyes anymore. Well... she probably doesn't notice, but she does look cute!
• Julia has been really good in mass lately, all things considered. She's usually quiet when she should be quiet, and she sings beautifully whenever there is music. Sometimes, she pulls out a hymnal when there isn't music and points at the music and sings, but she isn't too loud. She does shout out for "crack" sometimes, which probably makes people raise their eyebrows at us (she's no crack baby, I promise... it's just her word for cracker ;-) ). She loves going to church to see "Jee Jee" (Jesus, not to be confused with "Gee Gee" = Grammie).
• Julia's vocabulary continues to amaze me. She knows so many words. I lost track of how many words she knows so long ago, but it'd be a really high number. She's a verbal one. She does a fair amount of hilarious babyese as well, reading books out loud and running around monologuing. She's funny.
• Julia loves wearing shoes and hats and even hair bows. When she was younger, she tried to rip any nonessential garb off as soon as it was put on her, but now she likes accessorizing. I'm having fun dolling her up by fixing her hair :-) We also bought her her very own baseball cap - TU, of course. And taught her to say, "Go TU!"  Cutest golden hurricane ever.
• We have put Julia in the church nursery a few times on Friday evenings this Lent for the talk that follows the Lenten supper. The nursery workers are quite taken with her and they couldn't believe how well she played with other kids, especially considering many of them were quite a bit older than her. One of the volunteers asked me, "Is she around other kids all the time?" To which, the answer, of course, was no... pretty much never. She loves other kids so much, though. The other evening on the playground, she tried to play with some kids a few years older than her. She had this goofy grin on her face the whole time as she tried giving them pebbles. Puppy love.
• Speaking of love, we love Julia. A lot a lot a lot a lot.

Julia's Literary Discovery, Part II

We have been working with Julia on her ABCs. We got a book out from the library called My Foodie ABC: A Little Gourmet's Guide. I like food and I like helping Julia to learn, so I thought it'd be a fun read.

Umm...

This book is how I know now that I am not a foodie, because I had no idea what half of the things in the book were. Chanterelle, anyone? Xuxu? I thought those sounded like really out there names for dogs (maybe that celebrities would use for poodles and shih tzus, respectively). Opah? I thought it was what you shouted out at a big, fat greek wedding. Nopales? No clue. Luckily, there is a definition and description of each, but it's the most esoteric thing I've ever read to Julia, and highly impractical for a little girl growing up in this family. I make a mean chicken tikka masala, my tzatziki is legit, and my carnitas tacos are pretty delish... but that's about as ethnic as I get in the kitchen. I'm no foodie... or gourmet (G) or locavore (L) or even a vegetarian (V).

I got tired of trying to read the pronunciation key for all these obscure terms, so I started just singing the alphabet song as I flipped through the pages with Julia.

Aaron, however, must have let her linger on the pages quite a bit longer tonight, because she made a few new discoveries.

First, she found "Papa!" (her name for my dad).

Insightful?  Decently so. My dad isn't balding and doesn't peddle fruit (hard to believe, I know), but he does have gray hair and wear reading glasses, so she wasn't entirely off the mark. Aaron texted the photo to my dad, who noticed the key missing feature by responding, "Where's the moustache?"

Unfortunately, Aaron had to respond by saying, "Haha, apparently on "Mama!"

Yes, "Mama!"

Insightful? I hope not. Insulting? Probably. Should I use some of this semester's loan money for upper lip electrolysis? I wasn't aware of a problem... but from the mouths of babes?

To add insult to injury, here is the whole panorama.

Not only am I the moustached male in a flannel shirt and baseball cap selling avocadoes, there were even two females on the page that she could have chosen instead! One of who is definitely a "Mama!" pushing her smugly content toddler in a stroller (!!! sound familiar, Julia?!).  To be fair, I don't look that put together, especially not while shopping outdoors (okay... never ever). The other woman, though, is dressed much less well and is fairly pasty.  Why not her, Julia?  The red hair couldn't have been the reason (see below).

I think I liked her previous storybook "Mama!" better.

She may have been a muppet... with red hair?... no nose??... and pink skin??? (okay, okay, can't argue with that one)... but at least she was a female... and didn't have facial hair.

My main question is this: if her mother is a man with a mustache and her father is a monkey, how did she end up being so gorgeous?

"There can only be one explanation," Julia thought slowly...

She must believe that she was adopted.  A sophisticated face like that must come from people who cook with quinoa (Q), radicchio (R), and saffron (S), right?

Leap Day and Core's End!

It will be four years before I have another opportunity to post on February 29th, so I didn't want to miss out today!

Today is Leap Day, but, more importantly for us, today is the day that....

CORE IS FINISHED!

Our "Core" rotations are a set of four rotations during our third year that are considered to be our most demanding - two months of internal medicine, a month of surgery, and a month of OB/GYN.  Aaron did Core 1 (July to October), and I did Core 2 (November to February), which were different by design.  Since you have to work super long hours and a lot of weekends on Core, we wanted to make sure there was always one of us NOT on Core, so that person would have more time to spend with Julia.  That arrangement worked out well for our family, but it made for a looooonnnnngggggg eight months.  Most people rejoice when they get done with their four months of Core, but today, we rejoice because our family has been through a collective eight consecutive months of Core! 

We have plenty of challenging months ahead, but the end of Core is nothing to sneeze at!  

So, Happy Leap Day and Happy Core's End! (Maybe I can make "Core's End" an official family holiday...we'd only have to remember to celebrate it every four years!)

Julia and I danced like madwomen in the streets* as we celebrated the end of a dark era of boring work weekends, piled up dishes, and ghostly pallor from going into work before sunrise and leaving after sunset. Hooray for Leap Day and Core's End!  *Okay, okay, we didn't dance in the street, but a triumphant jubilant photo was needed to mark this special occasion, so we obliged.