Tired

These 10 hour days are really wearing on me and my feet... especially with the hour and a half commute, stop at the store, cook, eat, sleep approach...

Anywho, saw my first famous person today, he wasn't a pt. but was visiting one, unfortunately I cannot expose who this famous person is due to the Health Insurance Portability and Accountability Act aka HIPAA. This is a law that was passed a few years back to protect the privacy of pt's and their families. Fun stuff.

So I got my inservice topic that I wanted, thank you very much to the Therapist that gave me her topic and hopefully will help out with the student conclave I am organizing. I have to say most physical therapists I know are real helpful people (along the lines of reason of course).

I have seen many more "difficult" patients in the past few days in terms of different diagnoses and different levels of cognition. And my paperwork is getting real real good which is pleasant to have.
Quick side note: it is amazing that I can lock and unlock a car from 11 stories up just by pressing a little button, that is some amazing range.

Daily learning:
MRSA precautions - very common in hospitals and other health care facilities - “methicillin-resistant Staphylococcus aureus” - MRSA is of special concern because it is often multi-drug resistant, thus limiting treatment options.

Vancomycin - this is an antibiotic medicine meaning that it helps fight the infection caused by bacteria, it has a number of side effects. Side effects almost always unwanted and probably most pertinent to PT's as they may prohibit the ability to proceed with therapy. Vancomycin has a lot of side effects that you can check at this link.

Alright I am tired, time to try to squeeze in 6 1/2 hrs of sleep.
Last thing: 30 days, House, and Psych are some great shows.

You Make Me Want To...

Today was my first dealing with a whole lot of vomit and infectious disease, my clinical instructor (CI) keeps saying "you really need to experience someone passing out on you"
and I made ground beef for lunch tomorrow, yummy.

Furthermore... Tomorrow I hopefully find out that I can do my inservice on the topic I actually would like to choose: shortening length of stay, fast track, anesthesia, and how PT ties into all of this.
For those of you who don't know an inservice as defined by Wikipedia is a professional lecture, where professionals discuss research and cases involving their work for others in their peer group. It is a key component of medical education for Physicians, Pharmacists, and other professionals.

I love how we are part of "other professionals" while Pharmacists get mention... just another lack of respect issue...
Anywho, the inservice is required as part of my clinical experience, so I have to "git 'er done" and I will update you all on my progress (please don't fall off the edge of your seat just yet)...

Todays words of the day:

Cipro(floxacin) – Treats Anthrax! Also an antibiotic to treat bacterial infections e.g. pneumonia, bronchitis, gonorrhea, diarrhea caused by bacteria, typhoid fever, and bone, joint, skin, prostate, sinus, and urinary tract (bladder) infections.

HNP – herniation of nucleus pulposus aka “herniated disc”

The Ilizarov Technique - used for bone loss, leg length discrepancy, congenital or post-traumatic deformities, and osteomyelitis. Most notable to me in the movie Gattaca where leading man Ethan Hawke has to become taller to commit some identitiy theft this technique is used. The basic concept behind it is the following: the bodies natural reaction to a broken bone is to try to fuse the two pieces back together, so if a broken bone already exists they place pins in their appropriate places on either end of the break and over time pull the two ends of broken bone apart and eventually more bone will grow in thus making the limb longer. So in theory our friend to the bottom should have a whole longer body if the technique is done correctly.

Good night!

Monday's off are great

Although I have 32 errands to run, I enjoy having a day off during the week...

As part of my education I am learning at least one drug, one abbreviation and one condition per day, so you may see this at the bottom of some entries as I try to really learn this stuff and share with my loyal readers :-D

Drug: Zanaflex - brand name for the drug tizanidine - a muscle relaxer that really helps PT treatment by relieving the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis or certain injuries to the spine, and thus allowing therapeutic exercise that would otherwise not have been possible.

Abbreviation: PRN - as needed (from the Latin "pro re nata", for an occasion that has arisen, as circumstances require, as needed)

Condition: Diverticulosis - weakness of the small "pockets" along the large intestine (bonus, diverticulitis is when stool gets caught in these pockets and swells up)
- the suffix "-itis" usually indicates inflammation

Break from Clinic 1

The most amazing thing from my first week of clinic is seeing how amazingly quick patients can walk after having a total hip or total knee replacement. They can in fact walk the same day of surgery.

You get operated on at 9am, brand new hip or knee and we have you walking by 3pm. Of course the patient should be WBAT (weight bearing as tolerated) meaning they put as much weight on that operated leg as they feel they can handle. Sometimes though that can lead to some buckling which I got to experience this week. This is why the therapist has to be right there to gaurd against that (close gaurding assist- CGA).

Remember people: SAFETY FIRST!!!

Side note: my favorite blog, Evidence in Motion, put in a great entry about the Bush administration making a health care "festivus" at the end of September. During this week one of the biggest insurance companies that exist (the US government) will withold payment of services to health care providers on medicare patients. How much does that stink... Happy holidays to us... The entry on the EIM blog says it all a lot better than I ever could, I just wanted to bring it to your attention...
Good night.

Clinical Busy-ness

Wow, the sun rises real fast when you have a horizon to measure it against. The advantage of being up this eraly is seing this beautiful red ball go.

In PT matters though, clinic is real real interesting and real real time consuming. Since I am working 10 hours a day with an hour and a half commute each way, that leaves me with 11 hours of free time a day. I tend to get to the hospital about 45 minutes early and take about a 15 minute shower, down to 10 hours. I tend to give myself about an hour to get ready so I do not forget anything from home, down to 9 hrs. Have to cook some food for today, shop for that food, get a little exercise, post a little blog... I end up with only about 6 hours of sleep last night. No complaints though, I know there's people who have it much worse, what with the full time job of kids and all...

But clinic itself so far has been great. My CI kicks arce, the patients have been pretty darn great so far, everything is very conducive to learning. I got weaned into actually taking pt's on yesterday, very exciting stuff especially because of all the documentation involved. I planned on writing up a mock progress note to practice a little and give you, the reader, an idea of the documentation sheet in case it could benefit you somehow... But they are playing my song, I gots to gets goings... Hope you all are doing fantastico

BTW, how you like those brooms sox?

So Much To Read...

As I gear up for my first clinical affiliation as I have mentioned in the past few posts I have been thoroughly distracted by just about everything but physical therapy. Along with most of the links on the right hand side of this page, I have a few websites I try to check just about everyday to try to get the latest information. I feel this is vital to eventually become an evidence based practioner. But at the same time I cannot give up my fanaticism for the New York Jets (no matter how bad they get) or for the New York Yankees beating up on the B. Red Sox. Then I volunteer my time to coach football, help my mother with her business, babysit my nephew to help my sister. I also have bills to pay (doesn't everyone), loans to deal with, groceries to buy, food to prepare, working out to squeeze in somewhere in there.

All this tends to take away from me reading textbooks, although I did just order up $300 worth of new ones. Also, does not always allow me to push toward other academic goals I have such as re-certifying myself as an EMT and/or a CSCS. I have hundreds of thousands of papers all over my room that could use a good reading. I have actually had to cut out reading the New York Times every morning and I stopped subscribing to Men's Health which is a great lay source of information. So I am actually going to go ahead and read as soon as I brush my teeth, eat some breakfast... then go coach... clean up my room... ah, we shall see what happens.

Awkward Silence

It is my distinct opinion that two people can always learn something about each other, especially two people who don't know each other all that well. Bedside manner is something that cannot be taught but is vital to being a PT. As I prepare for my first clinical affiliation I am trying to get ready in everyway possible including working on my interpersonal skills. It's just always hard to fill those silences, and I always feel like it should be me who does it... fortunately I do not have that problem on the internet...

On a side note, it is interesting to have a blog because as I go through my day many of my thoughts start to come in blog form. Unfortunately I do not record all of them to share with you lovely people.

On a final side note for this post, my article I wrote about grandfathering the doctor title to all PT's made into the August issue of the Pulse (the newsletter of the Student Assembly of the APTA)

Vacationing

While I do have a whole week off before I start clinic, I am going to try to dedicate some of this time to actually prepare for this experience. I plan on visiting a few clinics and soaking up what I can. Also, I am going to research rheumatic diseases (Lupus, Rheumatoid Arthritis) because my clinic said this is a big portion of patients that I will be seeing.

FYI, here is the clinical breakdown for my program:

4 affils, of 6, 9, 11, 11 weeks in that order. You have to do an acute setting, rehab, musculoskeletal, and an "elective" of your preference. I am about to do the 6 week one, woot woot.

I also plan on reading as much of this text that I can, because it was published by the rehab department where I will be spending 6 weeks, so it may serve as a good reference. I will give a review of the book as best I can when I am done with it.

Last bit: an interesting news story from Michigan about a paralyzed dog that helps with the rehab of children with disabilities. Here is the link to the story and video: "Therapy dog to the rescue"
I have to credit to the UBC Physio info-blog for finding this story. It's great blog based on my short time reading it.

What'd You Get For...

This is the very common phrase recited by my classmates after just about every exam... because there are some tricky questions out there. Last nights final was a bit of a doozy but I fared well. However, after the exam I sat down with a classmate and tried to remember as many questions as we could, and we were able to recall about 30 that we both got right and about 15 that we might have or had different answers for, and 5 in the abyss somewhere, but everythings turned out just fine.

And as of a few minutes ago I just finished my 4th semester of PT school and I have until Aug. 22 to relax, but I probably won't.

I'm just a bit speechless right now, so off to the gym I go... Have a spectacular day to you all :-D

Final Stretch

With only one final this evening and one tomorrow afternoon... I am almost done with this dang semester and can move on to focus all of my energy on clinic and all that other stuff that goes on in life (finding a cheap flight to dallas... bills mainly... oh and actual socializing activities)

so this is what I think of these last two exams...
(Side note: that is no one I actually know, just a reflection of how tired [exhausted] I am of these exams)

Taking a Break

Down to one week left of summer classes... should be fun... since it's all presentations, practicals, and exams.

So here is my non-PT moment:
They are making Rambo 4!!! I already knew they were making a 6th Rocky, titled Rocky Balboa, but Sly is over 60 (and the plot sounds a lot like the old Governator's Commando) ... Craziness

BTW, Miami Vice was pretty darn entertaining...

Back to Vertigo & Dizziness.