Denvah... (spencah?)

so PT 2007 is goin great, I wrote a long entry while in the cab to the airport that I haven't been able to publish so these may end up backwards. I spent 14 hours getting to denver from ny, which is about 8 hrs more than it had to be but could have been much worse...
right now I am in a lecture about defensible documentation (not so much by choice...) but it has many interesting and vital points that all PT's need to be aware of.
These conferences are always such an enegy boost even though they tire me out because of the intense pace that ends up happening. So much to learn...
Being here has again made me realize how bad I am at remembering names... I recognize so many of the faces but the names just slip my mind... guess I need some brain room for PT stuff... as a note to self I want to add a 'muscle of the day/wk' to the blog, stay tuned for that... back to my ushering duties... if you aren't at this conference make sure you go to valley forge for nsc or nashville, TN next feb. for CSM, all the best... I hope this goes through :)

Denver...

In week 2 of my 9 week clinical affiliation I will be leaving half way through to go to Denver for the APTA's Annual Conference. There is a lot of great programming and I hope to meet some great candidates for next years student assembly board and nom com.

It has been rough writing entries whilst in clinic due to the physical and mental time commitment this requires. I had a similar decline in the frequency of posts during my last clinic affiliation as well. I hope to keep up with it as best I can for all your sakes :-D

I received a comment today on my last post and it was in what appears to be Portuguese, so I hope to translate it before allowing it to be on the site. The individual had a link to what appeared to be a blog of unique t-shirts... perhaps, we shall see.

In clinic I feel I am progressing well. Still seeing a lot of myofascial work, strain counterstrain, proprioceptive neuromuscular facilitation, and using various electrical modalities along with heat and ice. Each patient gets a minimum of 45 minutes and I certainly enjoy the time we are given. I really enjoy the care I am taking part in for these patients/clients and as cliche as it may sound it may sound I am excited for the day every morning when I wake up. Speaking of which I have to be up in less than 6 hours so I bid you all adieu.

Hope to see some of you in Denver for Annual Conference, and if you are a student PT or PTA I strongly urge you to consider running for a student assembly position as the deadline is really closing in on us (July 1st!). Election information, it's not too late... even if you aren't a big fan of the APTA, this is actually a great way to get involved and try to influence it to meet your vision of what the PT field should be doing. Have your voice heard and run!

I apologize for the bad photo editing and for those of you that don't know the face is of the current APTA Student Assembly President...

Clinic 3 days in

Need to go to sleep, but wanted to get this down...

Clinic is going great, learning a lot, seeing interesting patients...

Big focus in this outpatient ortho clinic on fascial release and the use of the very interesting strain counterstrain (mentioned in the last post)...

Most interesting patients in terms of diagnosis thus far have had a partial tear of the medial head of their R gastroc in a surfing injury and another patient had a fairly rare condition called meralgia paresthetica.

I am really focused, grateful and enjoying the experience.
Hope you are all staying healthy!

SFTR and SCS

Firstly, as you can tell by the title there is a lot of alphabet soup in the health care community...

Secondly, here are two interesting things I read about today...

Range of motion (ROM), which is how many degrees of motion a joint in the body allows in a particular direction, is normally given in regards to one movement at a time (i.e. the shoulder starts at 0 degrees and can flex aka move forward to 180 degrees [normally], this would be documented as R shldr flex 0-180).
An alternative method of documenting, which according to the Norkin text is not used very often in the United States, is the Sagittal-Frontal-Transverse-Rotation (SFTR) recording method. These 4 words describe the different planes of motion (note that coronal is another name for the frontal plane and rotation involves multiple planes). So in the sagittal plane, which is pretty much forward and backward, shoulder movement would normally be 60 degrees of extension, neutral would be 0 degrees, and flexion as stated previously would be 180... this would be documented S: 60-0-180 degrees).
As another note on ROM "normal" is very variable and usually the most important "normal" is to compare the amount of motion to the other side of the body (the "normal"/healthier side). As an example, shoulder flexion has been found to be "normal" anywhere from 150-180 degrees which is a fairly large discrepancy).Moving along... on Monday I start my 2nd clinic and my clinical instructor has recently had a case study published in JMMT. The focus of the case study was a patient with complex regional pain syndrome I (CRPS I - previously knowns as RSD) that was treated mainly with Strain Counterstrain (SCS). This technique in my brief understanding consists of locating tender points and placing the patient in positions of comfort (POC's) for a period of time (usually 90 seconds) to help "release hypothesized fascial restrictions" or "shorten the muscle tissue containing the involved hyperactive muscle spindle" (refer to this article - .pdf).

Off to rest before the 9 weeks of clinical learning... lookin forward to it...
hope you are all doing great out there and thanks for reading :-D

Take My Pulse

Here's an article I wrote for the APTA student assembly PULSE:

A few years back Al Gore invented something called the internet*. Since then it has grown a little. Now the internet has information on almost every topic. So what about “Physical Therapy”?

Hopefully we have all been to www.apta.org, which provides a wealth of PT related information and offers students a chance to interact through the “message board.” Another way to utilize resources on the internet is by accessing the numerous websites where you can search for literature related to PT, such as pubmed.gov and PEDro. Hooked on Evidence and Open Door are tools that can be accessed through the APTA website to search for literature. There are also numerous Web 2.0 tools that help bring PT into focus.

Web 2.0 is an interesting concept. It refers to a perceived second generation of web-based communities and hosted services — such as social-networking sites, weblogs, and wikis — that facilitate collaboration and sharing between users. People interested in PT can come together in groups such as MySpace.com, Facebook.com, Yahoo Groups, and even MyPhysicalTherapySpace.com. This last website was created by the EvidenceInMotion team to facilitate PT communication in a Web 2.0 way. Their other website evidenceinmotion.com is another very useful resource for our profession with a strong emphasis on evidence based practice. On the blog section of this site you can join in or follow along with some of the most innovative PT’s around as they discuss the issues we face in today’s health care environment. Another very good “evidence based” focused PT blog is can be found at http://weblogs.elearning.ubc.ca/physio/.

Feeding off this blog craze I myself decided to start such a blog as a student: http://studentpt.blogspot.com. My intent was to share my experiences with my program and get feedback from other students on similarities and differences with their programs. As I have continued updating my blog I have realized the mass of information available on “the net” and that students already have enough to read with lecture notes, textbooks and tuition bills, so how will they ever get to some of the vital information out there when it is scattered in so many places? More often than not there will be information missed, but careers will go on and the most pertinent information will find its way to where it needs to go.

One solution that the APTA Student Assembly Board and Nominating Committee have implemented is the Student Liaison Network. Information is filtered for the most urgent topics and disseminated to those in the network. Any student or faculty member can join the net work and become a liaison. All who are interested are encouraged to join to help share the information provided with their fellow students. To learn more and become a member of this network go to the APTA website, click on “students,” then “student assembly,” and then “student and faculty liaison network.”

As we move towards VISION 2020 the internet will obviously play a vital role in numerous aspects of our profession. How you choose to utilize this tool is up to you. For more technical support come join the discussion on the APTA student message board.

*Al Gore did not actually invent the internet despite what he may be yelling below...

Vacation all I ever wanted...

I didn't mean to quote the Go-Go's there...

I had a date with the boardwalk at sunrise the other day... it was a good run at 5:25 AM... did the boardwalk back and forth in 43 minutes (it's just over 5 miles supposedly)... Sopranos series finale was decent, it made sense to me, and I didn't mind them leaving it open-ended... hearing all the slack about the episode is a little disheartening as people just need to enjoy it! But it's a free country and so on and so forth... The Yankees are getting their act together, luckily the season is 162 games long so they still have some time...

So this is my week off before a 9 week clinical in an outpatient site. Just taking the week to relax and get mentally prepared. It is supposed to rain all week here which puts a damper on my vacation, but I suppose people in Seattle (the picture changes) deal with it right?
(Although it actually rains more in NYC than in Seattle...)

If anyone is in NYC in July-August you should check out this fantasy fitness speed camp... I will be there, so should you :-D

That's all for now,
Good night and good luck

Pre-Final Post

Warning: This post lacks a focus...

In my procrastination of studying/cramming I happened upon the EIM blog and there was a great quote I wanted to share (it perfectly expressed a few feelings I had in my head). These guys are doing such a great job and I wish them all the success in their endeavors cause it means so many great things for so many patients.

We believe that physical therapists are the heretofore unrecognized solution to many of our health care system's woes when it comes to managing musculoskeletal conditions. We are about 2-3% of the health care dollar and dwindling due to other things getting bigger. Despite what people think about our growing profession, we are actually shrinking relatively speaking compared to overall medical growth.

In other news, I swam 100 laps freestyle today, with only two breaks to adjust my goggles. My technique's and endurance are getting better every time I go out there.

So what of this final and class I have been taking? In addition to valuable manual techniques that we were taught, the ultimate goal of the class is to help us improve our clinical decision making abilities. In parallel to what will happen to us very soon, we are given a patient with a history and we have to rule out certain conditions, make sure they are appropriate for PT (within our scope of practice), come up with our own initial diagnosis, explain some treatments for it, and give a prognosis. I am grateful for classes like this as they are the meat and potatoes of what I want to be doing as a PT.
Furthermore, recently I have had a good deal of time to be reflective and would like to say how grateful I am for the gifts I have in my life and that we as humans have. Obviously some have it worse than others but it is necessary to be thankful for what we do have. And I also want to say "thank you" to anyone who is a good parent. From my short time babysitting my sister's kids I love them, but could not imagine doing that 24/7 and holding all the responsibilities that come with it. I am sure I will get that chance soon enough and I will rise to the occasion but it is such an amazing feat. So this is my unofficial tribute to the parents out there.

Penultimate

Had my penultimate class for summer I... lot of case studies... all leading up to the final on Thursday which should be mostly case studies... then a week off, then 9 weeks of clinic... see you all soon :-D

It's June already... boy, time flies...

I only have two classes left for this semester and then the final. It seems to be case studies the rest of the way and I like it. This gives me a chance to combine the knowledge I have gained from many different classes and apply it to one situation at a time. As a side note to this thought and a reflection on my last post, I have to say that mistakes made on exams and practicals are the ones that stick with me longer and thus I am a lot less likely to repeat them; it is all part of learning...

Moving along, I have been getting in better and better shape as the days go on, and the summer is a great time to get into even better shape... I encourage you all out there to make sure you are getting your AHA recommended minimum of 30 minutes of moderate intensity exercise most days of the week.
As I start to make my way into the world of marathons and triathlons I am just starting to get my name out there to be a medical volunteer. I look forward to the experiences I can gain in this arena with these very interesting athletes.

This post is just a plethora of thoughts...
I wanted to recommend the Hospital for Special Surgery eNewsletter (click on this link to register)

And I leave you with part of the lines I will recite for my niece's naming ceremony this weekend (it is her birthday today, happy birthday love!):

May you live to see your world fulfilled.

May your destiny be for words still to come

And may you trust in generations past and yet to be.

May your heart be filled with intuition

And may your words be filled with insight.

May songs of praise ever be upon your tongue

And your vision be on a straight path for you.

May your eyes shine with the light of holy words

And your face reflect the brightness of the heavens.

May your lips speak wisdom

And your fulfillment be in righteousness