Eyes, Ears, Nose and Throat Simulator

We have gotten hot and heavy into the primary care aspect of our education with our first simulator presenting with a visceral problem.  My patient presented with a head ache and was recovering from the flu she had supposedly experienced about two weeks prior.  She didn't feel like a real patient though, mainly because of her lack of physical findings.  When you have to ask what it is your are supposed to document, the situation becomes a bit weird.  If you don't ask, you don't get your finding - I learned this the hard way.  And they correct you if you don't do a procedure correctly, which is good to a certain extent.

The reality is that most people don't go to chiropractors for eye, ear, nose and throat conditions.  It is quite rare in fact.  The reason we are taught these skills is to recognize what I like to a call, the bad ugly's and treat the patient with conservative methods that do not involve drugs, which are, at times, equal if not better than medicinal approaches.   A good example is doing an opthalmoscopic exam on a patient with a head ache.  Why would you look in a person's eyes if they just have a head ache?  It could be many issues that are not eye or even head related, like a vascular problem or diabetes or hypertension.  The list goes on and on.  Another reason we are being taught primary care skills is so we can intervene early on.  For instance, if we find that there are vascular changes from an opthlamoscopic exam associated with diabetes in a patient who comes in for neck pain, we could order some labs to make the diagnosis and treat the migraines conservatively in conjunction.  If we couldn't recognize or if we were not allowed to use such diagnostic tools, we'd miss the boat entirely and the patient would likely progress into a worse state due to lack of treatment.  Most people want to see their chiropractor without a referral and some would prefer their chiropractor to manage the in's and out's of their overall wellness.  There is nothing wrong with this.

There is a lot of research showing that most back pain patients go to the doctor and their problem is biomechanical in origin, while a small percentage of folks with back pain have a "bad ugly" lurking in them.  The issue is that the medical management of back pain or musculoskeletal pain revolves around treating the symptoms of pain through the use of anti-inflammatory's and muscle relaxants.  Our approach is to find restrictions in segmental movement, rule out bad ugly's and avoid the use of pharmacology.  If we were to prescribe meds to all back pain patients just like our medical counterparts, our patients would most likely injure themselves again, and again, and again because their problem is a biomechanical one, not a lack of pharmacology in their blood.  Make sense?  We are best at treating biomechanical problems and able to diagnose and manage the bad ugly's if they are present.  Neither situation is easy to manage.  The funny thing is, biomechanic problems are at times more complex than the bad ugly's like tumors or infections.  

I have a clinical nutrition exam to start getting prepared for and a little wifey who is coming to my pinning ceremony this Friday, which means I need to get all this stuff tackled early!

All for now and thanks for reading!