I have often heard it said that if you love your job, you will never work a day in your life. Looking now at the fruits of my labor, I don’t know that I agree with the statement.听 I think that it would be more accurate to say that if you love your work, then the effort put into completing the tasks will feel like it has worth. This has been a challenging experience every step of the way, and I would be lying if I said I never had doubts or thought about throwing in the towel. Growth IS challenging.

If you choose to take a journey like this of your own: beware. There will be casualties. Some more physical and others abstract. Parting with unconstructive thought patterns and aligning with ones that will serve you as you move forward, is probably the most difficult. With that said, today, I am someone that the “me” of eight years ago would have a difficult time recognizing, and there is a lot of pride in that knowledge.

Come Friday, this chapter of my life will be coming to a close. It is bittersweet. I am so happy that I made it here, but there are things that I will miss. It will be the people mostly, school friends who have been there every step of the way, sharing laughter and tears. Then there are all of the wonderful mentors that I have found along the way, guideposts helping me to stay the course when I felt the path was unclear. The lack of a commencement this term does leave me wanting for a greater sense of closure. I have attended many ceremonies over the last few years, and I find that I am sad that I won’t have the chance to hear them call “Dr. Sarah Louise Montesa” to the stage, or to say my Hippocratic oath with all of my peers. It is just something that comes with the territory of being a part of the class of 2020.

To end on a happier note, board scores were posted today: I passed them all with flying colors, and there will be many years ahead of me to be called “Dr. Sarah Louise Montesa.”

听Thank you for being my readers. I hope that some of the messages relayed throughout my time writing for this blog will help on your own journeys.

Take Care! — Sarah Montesa

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To become eligible for either of these options, you need first to finish all of your graduation requirements. That means being evaluated by your supervising clinician on your proficiency in certain areas, including medical interviewing, physical examination, therapeutic skills, clinical judgment, patient counseling, organization/efficiency, radiology, as well as ethics and professionalism. We each also submit a 30 item portfolio of meta-competencies and three co-curricular activities where we show how the outside volunteer work that we completed during our time in the clinic will affect us moving forward into practice.

I completed my last few tasks shortly after returning to the clinic and spend much of last week saying my goodbyes to the patients who have entrusted me with there care over the previous year. It was bittersweet, I am grateful for all that I learned and I will miss the interactions with these people, but I am excited to have the time to observe and figure out what needs to be done to ensure the best possible start to my own business.

The two-week observation is just that. The student goes to shadow in a clinic watching from the outside. We are not allowed to work in the clinic that we shadow in the same way that we would work during a preceptorship. I have written in the past about how good it is to shadow throughout your time as a student so that you can get a feel for the different ways that things are done and decide what fits. This is the last chance for me to do this under the umbrella of being a student, so I hope to make the best of it.

Well, there are three weeks until graduation and one last posting to go before we part ways. I am looking forward to sharing my final thoughts on my school experience with you as everything comes to a close.

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1. Have a plan. It’s good to get an idea of what you need to know for the test and then set aside time each day to look at things. This does not have to be a lot of time; if you start early, you could spend 30 minutes a day, and it would be more than enough. I liked using checklists to keep track of what I had been looking at, and if there were something that I felt shaky on, I would mark that down as well so I could revisit the subject later. It’s also good to track what time of day you feel at your best when you are most alert and focused and arrange the schedule accordingly so that you make the best of the time spent.
2. Know when its time to quit. Check-in with yourself. Are you retaining any of this? How focused are you? This rule applies when you should stop looking at things before the test itself. I usually make my cut off sometime the day before the actual exam. This makes it possible to rest before having to do a bunch of heavy mental lifting. Which brings us to our third tip…
3. Get enough sleep. Your brain needs sleep both before and after learning in order to commit information to your long-term memory. There have been lots of studies that look at how sleep affects mental and physical health. Staying up all night to learn something at the last minute is not a good way to prepare for a test. If you are not convinced or would like more information about this, check out this TED talk:
   
4. Find a variety of resources and stick with the ones that you like best. This applies to textbooks as well. Sometimes, I would get more out of a supplemental book for a class than the primary one. Talk to your peers; there are many different study guides out there, and they are likely floating around on people’s thumb drives so it never hurts to ask. Some of my favorite resources were in video format. I was able to have them running in the background while going about my day. Sometimes I was not mentally in the mood to read anything, and this gave me a way to gain information more passively. I used videos for both the acupuncture and the chiropractic boards; I hear that there are ND videos too, so a little something for everybody.
5. How you feel after the test does not necessarily correlate to the score you will receive. It’s not unusual to feel like you did terrible walking out of a board exam. As a rule, they tend to be mentally taxing, and when you factor in the stress from thinking about how this will affect your future ability to work, it is no wonder that people are wiped out after taking the test! Eat a good meal and try not to dwell on what you did or did not do well. You will be applying for that license before you know it.

It feels good to have it all done! Now it is just a waiting game until the scores are posted, which will take about a month. It is hard to believe that one month from now, I will be a graduate. This has been a long time coming, and I am excited about the next chapter!

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Mulberries are the fruit of my childhood. As a kid, there was not a summer that went by where I was not gathering as much of this fruit as I could eat, leaving only the purple-blue stains from the juice behind. The fruit contains a variety of nutrients and fiber and in traditional Chinese medicine it gets used in formulas to help with constipation and promoting body fluids.

This year was the first that I cooked with them, and the mulberry jelly was the best of the experiments. Fruit jams and jellies are easy to make. You can make them with pretty much any fruit you like. Here鈥檚 what you鈥檒l need:

Ingredients

• 听听Mulberries approximately 2 pounds
• 听 听1陆 cups water
• 听 听Box of no-sugar Pectin like Sure-Jell
  (You can usually find it next to canning jars in the grocery store), 1.75 oz.
• 听 听1录 cups Sugar
• 听 听1 T. Lemon Juice or 1 tsp Citric Acid
• 听 听1/2 t. vanilla extract
• 听 听1-2 T. of cinnamon
• 听 听听1 T. of grated ginger or ginger powder

(The last 3 ingredients are optional and can be adjusted to taste)

Process

1. To begin, put washed berries in a pot with the 1/2 cup of water. At this time, I set up an additional pot of boiling water to put my canning jars in. Boil the jars and lids for at least 10 minutes to sterilize them.
2. Bring the berry mixture to a boil for about 10 minutes, mashing them with a fork or potato masher.
3. Once the big chunks are broken down, pour the berry mixture through a fine strainer so that only the juice remains.
4. Put the mulberry juice back in the pot and add in the sugar, pectin, and other ingredients. (The pectin directions may ask you to set aside 1/4 of a cup of the sugar. Mulberries are a low pectin fruit. The pectin helps them to jell without cooking down the mixture with a ridiculous amount of sugar. Apples are a high pectin fruit, so potentially, you could add them to most jam or jelly during the cooking process to help with the consistency).
5. 听Bring to a rolling boil for about 1 minute and then remove from the heat.
6. Now you can ladle the mixture into your jars. Leave about 1/2 of space at the top and secure the lids.

I leave them out on the counter until they have completely cooled; overnight is fine if that is how the timing works. Then you can refrigerate if you like, but only open jars really need to be refrigerated.听Enjoy!

Check out more healthy recipes from Sarah here!

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听

To my surprise and delight,听while all of this was going on, an email from the state came saying that I am officially a licensed acupunturist now! So, most of this past week’s free time has been spent setting up my LLC, getting my 911爆料 Provider ID, and my employer identification numbers all applied for. Signing up for malpractice insurance is next on my agenda, and then I will begin some of the more fun stuff like social media promotion to try and get some people in the door to see me. The whole thing is exciting 鈥nd terrifying. My DC clinician reassured me that it would be fine; everybody had a first day in practice.

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I am looking forward to sharing what that was like before the end of my time as a student blog writer. As I watch things fall into place, I am pleased with the way I chose to go about completing my schooling.听 It will be nice not to worry about what happens post-graduation as I continue to do what I have already started.

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Enter, “Gardening is beneficial for health: A meta-analysis,” whose concluding statement is that “a regular dose of gardening can improve public health.” The studies included in the meta-analysis looked at everything from decreasing anxiety/depression and increasing cognition to reducing听BMI. I can speak from experience that gardening can deceptively yield an excellent workout; with some patients, this could be one way to ease them into exercise without them realizing it. If you encourage the cultivation of fruits and vegetables, a patient will likely include them in their diet as well. I know my kids will eat things just because we grow them that they might otherwise fight with me about, literally enjoying the “fruits of our labor.” Kids especially benefit from time outside interacting with plants; things like inattention and impulsivity have been shown to drop as kids interact with natural settings.

Our home garden has turned into a group project. I enlisted the kids to help paint boards for our new raised garden. My son helps water the plants鈥nd his sister. My daughter. Well, she looks for insects (they are ALL her friends, and she tries to bring them in the house). In a world where so much feels out of control, it has been helpful to shape the space around me.

(Left to Right) Before and after.

The next time I write, I will have taken Part 2 Boards. It still doesn’t feel like it is actually happening, but I got an email with the test center’s procedure, so it must be. Wish me luck!

Source to share: Soga M, Gaston K, Yamaura Y. Gardening is beneficial for health: A meta-analysis. Prev Med Rep. 2017;5:92-99. doi:10.1016/j.pmedr.2016.11.007

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The student clinic is still closed, which has been less than ideal, but the assignments are interesting, and I still feel like I am learning. As of right now, the plan is to have us back in the clinic in July. It seems that we may begin doing some tele-medicine soon, but I will let you all know how that unfolds.

My children are also coming to the end of distance learning for this school year. It has been a struggle; my son is an expert in getting into trouble with the computer. So鈥e have been coming up with different activities and non-computer-based projects to keep them engaged in the learning process. My basic science education has come in handy.

We experimented using acids by dissolving the shell off of an egg with vinegar. This gave us a semi-permeable membrane, so, we looked at osmosis by watching what happened to the egg in hypotonic and hypertonic solutions. The kids also surveyed people and we charted our data, looking at how sample size affected our results.听Lots of messes have been made.

Well readers, that鈥檚 all for this week. Till next time, stay healthy!

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For the bulk of this past trimester, up until shelter-in-place was instated, I had been working with a Spanish-speaking patient regularly. While the patient chose to continue to see me despite the language barrier, I always felt I could help more if my ability to speak was better than some broken phases and pantomime. For the most part, anytime I have ever had patients who did not speak the same language quickly became an amazing and accommodating teacher, amused by the song and dance I put on to communicate with them. But still, I think I can do better.

Aside from my adventures in foreign language study, I found a class from Yale University, 鈥�Addiction Treatment: Clinical Skills for Healthcare Providers.鈥� There are a ton of free college courses to choose from on the Coursera site; all offered by Ivy League schools. The class I picked is geared toward health care professionals who may not necessarily be involved with the mental health field. It teaches concepts in working with patients who have substance use issues, through motivational interviewing techniques. The big take away so far is that it takes a village to help someone who struggles with addiction. Sometimes just being the person a patient feels they can trust and talk to without being judged may lead them to be more receptive to suggestions about treatment programs that could give them the help they need. The way of speaking involved with motivational interviewing techniques lends itself well to chiropractic medicine. One of the primary aims is in gathering information that can help the provider to know the best way to motivate the patient to modify behavior and lifestyle–as that is the world we live in.

As much as I am learning right now in our home assignments, I miss taking care of people; it’s why I decided on this profession, after all. I hope that the next time I write, we will be getting everything ready to be back in the clinic, but only time will tell. Take care until then.

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Not knowing what the future holds when you have carefully planned every aspect of your life for the last few years is frightening. So, what’s the plan now, you might ask?听 It’s time to stop focusing on what is out of my control and exact change upon the things that I can. Ignoring the news for a little bit and limiting social media is important; it’s too easy to fall down the rabbit hole, the information becomes all-consuming. Next on the agenda is to get the children and me back on some sort of schedule. It is really easy to stay up too late these days. Right now, setting up a structure is paramount, and is sure to make a difference in the mental health of my family. Between the kiddos homeschooling and completing all of the writing that I have been doing for clinic, there is plenty for us do.

On the bright side, getting outside every day is getting a lot easier. The sun felt so nice today. There has been a whole lot of moving and creating going on. There has been cleaning and decluttering of both the tangible and intangible. Also, I speak to my mother every day on the phone now; we chat about everything and nothing, showing that closeness can be created even in physical distancing. This is not meant to be easy, change never is, but I am looking forward to seeing the world that is on the other side of this.

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In our home, we wake up when we wake up, and then I work with the kiddos to make sure our set tasks are being completed. Time has become irrelevant and by nightfall, I am left wondering where that day has gone. It’s funny that months ago, I was considering telling my son that he could be homeschooled next year if he wanted to be, and now we get to see what that looks like as we scramble to put together things to work on (the kid’s school has been helpful). All things considered, I feel like the children are thriving in this scenario. We learn abstract things together, play games, build stuff, and do all of the things that I might have been too busy to appreciate just two weeks ago. For now, the only thing to do is take one day at a time and relish this opportunity to enjoy the little things.

As far as clinic goes, we will be having daily assignments and articles to read for at least the next two weeks. At this writing, we are just two days into this new schedule, but I have already learned a lot. Every task is entirely relevant to caring for patients and documenting in a way to make sure that you get paid to do so. I miss seeing patients, but at the same time happy that I do not need to be a vector for disease. If the last two days are a reflection of what is to come in terms of learning, I will be better equipped to take care of my patients once we are back to work.

In other news, I passed all of my Acupuncture board exams!!! It was a stressful six weeks waiting for those scores to come back. Now, all that I have left to do is send my application for licensure into the State of Illinois. I just so happen to have a bit of time on my hands right now, so I will probably also be setting up the LLC for my business and getting stuff together for a webpage.

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