Choosing A Text

I just found out that my last affiliation is going to be at a Spinal Cord Injury center. This is admittedly not my strongest area of expertise so I just purchased a text to get caught up. That's all for today, hope all is great!

Our Healthcare System

I wanted to share this experience from a few days ago...

I had an initial evaluation of a 76 y/o female

The prescription had a diagnosis of bilateral radiculopathy of the shoulders and a box checked off for "evaluate and treat"

She had a fairly extensive past medical history that I will leave out as well as a few clinical findings secondary to lack of relevance.

As I went through the patient interview, radiculopathy was less and less a likely culprit in her shoulder pain. Although she had a positive neer, hawkins-kennedy, and yocum special test, they simply created pain in the same location where just about any movement caused her pain. Moreover there was no radiation of pain which can be common in "radiculopathy". Distraction and Spurlings tests were negative. Also, the Yergason and Speed test were positive and the bigger piece to the puzzle was the fact that the only area of tenderness was on both biceps tendons.

She went on to describe that when she had pain in her hips and knees about three months ago she would use her arms to help her get up out of chairs. Her shoulder pain developed in conjunction with this other pathology.

Her MRI report from two weeks ago showed that she had minor tears in the infraspinatus, suprapinatus, and subscapularis along with minor arthrosis. She said her doctor mentioned only a possibility of bursitis and she claimed he never looked at the MRI report. NSAID's and aleve provided little to no relief.

Ultimately all signs point to bicipital tendonitis. Now we must call up the MD to report our findings. Ideally, there was no need for the MD visit. The patient could have saved herself that trip and extra payment that accomplished nothing more than referring her to us. We were able to screen for any red flags and are certainly able to refer elsewhere if there is an issue present outside of our scope of practice. For musculoskeletal issues PT should be the first line of defense aka the practitioner of choice. Unfortunately, this patient is one of many such cases and the situation will be one big speed bump to overcome, but it certainly is worth the fight.

PT - Poetic Therapy

Tried to pull an all-nighter to finish up some revisions
due right about now
ended up watching a lot of def poetry jam on youtube
i am by no means a poet as you will soon be able to tell
but i got tired of always being inspired
and always saying "i could do that"
so i may not have something as powerful to talk about
i may not be able to wordsmith or rhyme
as well as those guys with all that time (see)
but i realize they dont rhyme all the time (dang)

i figure let me not delete anything in my "poem"
let it flow
thats the way to go...
plus its all in the delivery right?
granted this is via blog
so the delivery doesnt add much
instead of def poetry you get flat words with no emotion
but trust me its coming from the heart

like the heart of my patients
who all have patience
for a youngster learning the ropes
but they all seem to get better
so who really is clever :-D

but thats what i really wanna talk about
my patients
i went to a career day recently
not to change my own career path
but to speak to high school kids
about what i want to do with the rest of my life
and see if they may wanna join

one young girl
asked about my payroll
after revealing the median salary info i knew
i added something to clue...
her in on the reality of why i do what i do
i said
we do not do it for the pay
we do it to make the patients gay
and not gay the way you as high schoolers will giggle
but how it used to be used when literature meant something
i get paid with a smile
of patients who hadnt been able to walk for a while
you act as a teacher, a motivator, a friend, a confidant
one that molds the clay that is the human body
back to its optimal form
its a powerful thing
changing lives one motion at a time
one exercise, one soft tissue mob, one love

i choose not to rhyme for sake of time
but moreso because i cant
what i can do is help give patients
the tools to heal
hopefully
not everyone is a success story
not all will be pleased
i wont always be pleased
but for now i go to do my passion

because if its something you actually like
its not work
and if you can get paid and live a good life
isnt that all that we can hope

so forgive me for my semi-prose style
i hope it brought you a smile
at one point or multiple
all i know is im triple
as happy as i was 3 years ago
before i knew all there is to know about the elbow...
theres always more to know, dont lie to yourself
anywho, off to get an hour or so of rest
before i put on my best
for my friday patients
who have patience
with this sleep deprived
passionate child
who has so much to learn all about life
and cant think of a clever way to end this phrase
so here he stops
and wishes you all a quick rise to the top

ill try to do better next time... :-D
have mercy

Vocabulary energizers

cic·a·trize (sk-trz)

v.

To heal by forming scar tissue.

Fabella

Popliteus muscle

In situ

prn

Saw my first spinal cord stimulator in action yesterday. Interesting stuff; the patient reported that it provided relief along the left side of her spine but not the right following a spinal fusion 2 years prior.

A rebar acts to prevent collapse.

Curettage

Radiculopathy

Spondylosis

Spondylolysis

Spondylolisthesis - A straight leg raise may be uncomfortable or painful
Symptoms

• Lordosis
• Lower back pain
• Localized tenderness over the spine just above the pelvis
• Pain in thighs
• Pain in buttocks
• Tight hamstrings
• Stiffness in back

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PS, the freakin' CPR class was canceled and no one informed me... what a waste of a Sunday morning, ah well, I get to hang out with my nephew and niece.

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