The Last Day

My last day was a short and sweet one. There were only two patients that came in while I was in there. One patient has had cronic back pain so Diane did ultrasound on it and worked on pulling the scapula out to loosen up the tissues around that scapula. I was suprised to see how easily and how much the scapula would come away from the body. The second patient is one that has M.S. She has been coming to see Diane for many years now to work on balance because that is something that is effected when you have M.S. With M.S. you are also effected a lot by fatigue, heat, and stress. It is interesting because this M.S. and Parkinsons have been apart of studies that say they could be environmentally caused. The patient that we saw's sister had Parkinson's, and the neighbor had something similar as well. They also drank a lot of ground water when they were younger so that could explain why they have these conditions.

May 26
Worked: 9:00-12:30, 2:00-4:00

The patient that had had Carpal tunnel got surgery on one of her hands. The surgery lasted a whole seven minutes long with local anesthesia. This surgery entails the doctor cutting the traverse carpal ligament. By cutting this ligament, pressure is released on the medial nerve. Obviously, the hand was all wrapped up, so you couldn't see anything, but I made sure that the patient would email me pictures once she is able to take off the wrap. There was bruising that went half way up to her elbow past the wrap. Unfortunely, she still has symptoms in the other hand and up into her shoulder because the symptoms move up the arm, which seems peculiar.
The rest of the morning consisted of seeing other patients that we had seen before, and mostly doing the same exercises as they normally have. Diane did have a phone call in the middle of the morning from an insurance company, and expressed some irritation with them because as she explained, the people working there have no medical knowledge, and do not know about patients' conditions, and how many times they will need to go to physical therapy. Fighting with insurance companies to let them allow patients to get more visits is something I feel like I see Diane doing a lot.
This afternoon, because I didn't have sports, I was able to stay for the rush of Proctor kids. I harrassed Sam Johnson to  let me take a few pictures of him for my exhibit next week, which only seemed fair after I was interviewed and put on video camera for him, and assisted some more injuries that I had never seen before. Tomorrow is my last day, how sad! This whole term has gone by so quickly..

The Last Off Day

Another Wednesday goes by that I didn't have to work. I went to woodworking, because I am just making a cutting board for fun. Today was also my senior game for Lacrosse. We played KUA, who we had played previously and beaten, but this time we lost by one, with thanks to an awful call by the officials in the last 30 seconds. Now I will spend the rest of my night studying the shoulder for my test on friday. The bones that I have to know are the Acromion, Clavicle, Glenoid cavity of scapula, the humerus, and scapula. I also have to memorize the subdeltoid bursa. The muscles are the deltoid, trapezius, the muscles in the pectoralis major muscle, supraspinatus muscle, infraspinatus, subscapularis, and the teres major and minor. Theres alot to memorize!

Today was a short day. Diane had a dentist appointment, so there were no patients until 10:00. First the patient that had had the anterior hip replacement came in, and she is progressing with her exercises very well. Because she was using her other leg so much the months before she got the hip replacement, the muscles in her other leg is still getting used to being used.
No that I have seen the patient that had rotator cuff surgery, I was able to pretty much do the majority of his appointment with him. Diane was with another patient, so that is what enabled me to do this.Another patient that I had done their exercises with them previously had re-injured their knee so it was quite swollen, and had to work on reducing the swelling before going back to the exercises she was doing before.

Today we saw a new patient that had an interesting surgery. She has had scoliosis for quite a while now, and opted out of getting the surgery when she was younger because it would have kept her in bed for a very long time; a much more significant time period than post-op now a days. Since she had such a drastic curve in her spine, she had two Harrington rods put in, which are stainless steel rods that are used to correct curvature of the spine or give stability to spinal fusion. The spine was wrapped in places with the two rods to straighten out, and while the spine is not completely straight, it has much less of a curve. After the surgery, the patient is put in a bed that holds them by the skull and has a circular thing around it so that the patient can be flipped from their back to their front. No the right scapula is causing the muscles to pull, causing the patient discomfort, and that is why she is at physical therapy. Just looking at her back, you notice a large bulge on one side of the back, so first it was ultrasounded and stimmed. Following, Diane did a stretch with the patient in which she pulls the head back, when she is laying on her back and then drops the head down and rotates it from side to side to work on range of motion. The patient is only able to do this 3 or 4 times.
There were a couple of other patients today, all of which I have mentioned before in my blog. Today was very interesting, and I hope I get to see more unique circumstances like today's in the last few days of my project.

Week 2 Reflection

This week brought on a lot of the same events, and also some new ones. We continued to see a lot of the same patients, because they come in a few times a week, and it is interesting to see how they progress and see how physical therapy can really effect people’s bodies. It is interesting to see that some patients have been coming in for years because of things like Parkinson’s, and that it is a crucial part of their lives. A lot of patients rely on the relief of pain that they get from physical therapy to get them through the week. When you hear patients telling Diane that she is a god to them once they leave, it shows you how much what she does can really help people out, and I am lucky to witness that and do my best to help Diane with anything that I can.
    I had my quiz on the knee this week, as that was one of the joints that I wanted to learn about like I stated in my proposal, and I got 100%. Looking back at my proposal, I had said that I wanted to learn 3 joints, but because of time, I will only be doing two. Now I have moved onto the shoulder, which I am excited about learning about because I have seen so many shoulder injuries come in, and it is always nice to know what we are working on in particular.
    Understanding how Diane deals with insurance is interesting. It is interesting, because there is a patient on Medicare that is waiting to see what the bill will be because his therapy is not crucial and will probably not continue therapy if the cost of the appointments is too much.
    In my last week, I hope to continue working with patients as much as I have been lately; being an active member of appointments helping stretch, ultrasound, electirical stimmulation, do exercises, and clean tables after appointments and learn more about the business as a whole. Electrical stimmulation is when an electric current is used to contract a muscle or group of muscles. Going through a normal day I learn a lot about it just by observation, but I am sure there is alot more that I could possibly learn.

Short Day

Today was a short one. Diane was going to Tom Eslick's service, so we were only in for an hour and a half. The first injury was a knee injury when he had gotten hit in the knee and even since has had pin point pain in the side of his knee. Doctors have said that it is hurting from something else but because it is pin point pain, Diane thinks otherwise. The next patient is one that had had shoulder surgery that I have seen multiple times. He is having aches in the shoulder in this weather most likely because of the moisture and barometric pressure.
The rest of my day was spent finishing my bed and spending time with friends. I have lots of studying to do in the next week but I look forward to getting back to work!

May 19, 2011
Worked: 8-12:30, 1:30-2:45

Today started with my quiz on the knee. I got a 100%! So now I have to move onto studying the shoulder which has alot more parts.
This morning was full of patients. There were back injuries, knee injuries, carpal tunnel, and the hip replacement. Having this many appointments made it possible for me to do more with patients. I did ultrasound 3 times and observed a couple patients with their exercises. However, at the end of her exercises, we were working on the total gym and her knee started to creak quite loudly. Today was the first knee injury that I saw, which was nice because I was able to relate to her and I also understood the exercises that she was doing. The only appointment that I really cannot help with it is the patient that has fluid in his lungs, and because of his cancer treatments, he cannot have ultrasound or stim. Diane only can massage the liquid to both the heart and the lymph system. I came back in the afternoon to get my hours in for the week, because Diane will be at a funeral tomorrow. Because of this funeral her father stopped by, and for a while the office was packed! The man that is getting his leg amputated from the knee down because of blood clots was in and he is doing well but I am suprised at how positive he is, becuase I know if I were in his situation I would be extremely negative and probably depressed.

Today I was unable to work because Diane wasn't working until 12:30, which is the time I had to leave with my team to go to Vermont Academy. I got up, went to breakfast with Elyse because I promised her, and headed to the woodshop. I continued to work on my bed, it will probably be done this week, so I can bring it home when I leave for the weekend. After I spent some time in the wise and discussed Fenny's tiny blog entires with Sophie. After a team lunch, we headed to Vermont to beat them 10-5. It was not an impressive game on our part, so I'm sure we will be running tomorrow!!

Fifteen Minutes of Fame

May 17, 2011
Worked 9:00-12:30

My day started off with a visit from Sam Johnson. Since he was able to go a visit without complaining, it was only fair that I did the interview with him. I was nervous because I do not like to be on camera, but I think that I did alright. After the interview he shot me doing things like cleaning the stretching tables, taking off stim things, and putting towels away. Let's just hope that now that he has gotten what he wanted, he will continue to go through appointments without attitude.
The patients today were some new patients and some older ones. The patient with carpal tunnel is continuing to have swelling, after she is off medication for the pain. The new patient we saw today was one with parkinsons disease. His weaker side is his left. Mainly what he works on is strength and balance. Walking up stairs used to be very hard, but seem to be getting easier.The exercises that he works on are doing step ups both on the side and forward, walking on his heels and toes, and walking over cones with a side step.  It is also very hard for him to stand up straight, so he gets neck pain as well.
My quiz on the knee is this Thursday. I have the majority of the parts down. I always forget the popliteus tendon and the Gerdy's tubercle, because they have such funny names. I have one more day of studying left!

Worked 9:00-12:30, 1:30-3:00
May16, 2011

Since there was no blog yesterday, I guess I have to tell the answer to the riddle now. The answer is neither becuase 9 plus 3 is not 13...

Today was a day full of patients that I had seen before, so it was interesting to see how they are progressing. The woman that had had the full hip replacement is doing better, but still has swelling in the knee and a tight IT band. Another patient, that had had rotator cuff surgery is now able to not do isometrics and is regaining strength with every visit.
Diane also saw a patient that I am not sure that I had mentioned in a previous blog, but he is a patient that has fluid in his throat and because of cancer treatments, the only thing that she can do to help is massage. Diane works on moving the liquid to the heart and the armpit. In the armpit there are Axillary Lymph Nodes that can help to clear the liquid out.
Sam Johnson came in this afternoon, and per his request he is getting this shout out in my blog. He was able to go an entire appointment without complaining, but we put him up to the challenge again today. He did not do as well today as he had previously, but he still got his interview with me tomorrow morning at 9:00. Wish me luck!

Weekly Reflection

    As the week went on, working at Ragged Mountain Physical Therapy got better and better. I got more comfortable with working with patients, and there are even things that I can do by myself. At the beginning of the week, I was simply observing and trying to understand the injuries that were coming into the office. Now I am an active member of the appointment, and understand why the exercises or massage or ultrasound is being done, because I somewhat understand what is going on with the injury.
    There are not that many appointments in the morning while I am there. Because Proctor kids are such a big part of the Andover community, they are also a huge part of Diane’s business. The Proctor kids of course all come in the afternoon during sports times, when I am not there, which is dissapointing because I think I would be able to work with them more then I am able to work with the older patients.
    As for my studying, I have a quiz on the knee this week. The parts are really hard to memorize, because there are so many parts and some do not have real reasoning as to why they are named that, so I have been simply re-writing the names, but I need to do alot more before my quiz.
    As my project continues, I look forward to been more involved with appointments and gaining a better understanding of the injuries that are coming in. In the next coming week, I need to focus more on the business itself, and learn more about how Diane deals with the insurance companies. I am unable to do any work with the paper work, but understanding of what Diane does is something I want to do. I have read a few people’s files, and I am working on understanding the abbreviations and what the doctors are talking about. The O.R. reports seem like a different language when I read them but Diane is working with me to better understand what they do during the surgeries, and I want to continue to learn more about common surgeries.

May 13, 2011
Worked: 9:00-12:30

This morning started out with a patient stumping me with a question i had never heard before, but he expected me to know because I go to Proctor. Which one is correct? 9 and 3 are 13, or 9 and 3 is 13? ( I will tell the answer in the next blog) I answered incorrectly...
After a Jakes run for breakfast, Sam Johnson came in. Sam has a tendency to complain at P.T. when he comes in for his appointments and has also been asking me non-stop to do an interview on camera for his senior project. When thinking about these two things, we decided to make an agreement. If Sam could go an entire appointment without complaining, sarcasm, or attitude, I would do the interview for him. Needless to say this was very difficult for Sam, especially when he was outnumbered by women 5 to 1 and they were talking about the not very positive qualities of men. In the end, he got his exercises done quicker then ever before, and stayed silent the entire time to avoid slipping up.
I am able to do more things with patients now, like stretching, giving ultrasounds, and stim, and the day keeps getting busier and more interesting.
The day ended with a trip to R.P. Johnsons to look at screen doors. Diane needs one so that we can get fresh air without all of the annoying black flies.

May 12, 2011
Worked: 9:00-12:30
There were no new patients today. The patient with carpal tunnel came in again, and she had the pleasure of having Diane and I ultrasound both of her hands at the same time, and a deep tissue massage which she did not like at all. She continued with her routine until the next patient came in, that had undergone rotator cuff surgery. A missing page from his O.R. report finally let us know what they had actually repaired, information that Diane had had to infer about before this point. His ROM has gotten much better and he will soon be able to cut out some of this more easier exercises. It is nice to see patients achieving some of their goals and to be progressing with their therapy. The woman that had had anterior hip replacement came in as well. She is progressing as well, but like many people after surgeries, wishes the rehab was going faster then it is, however she did add more exercises to her list of things she could do to strengthen the leg.
The material of studying increased today, when Diane was teaching me that there were actually four different muscles that make up the quad; the vastus lateralis, vastus intermedius, rectus femoris, and the vastus medialis. There are also 4 parts that make up the hamstring; gracilis, semitendinosus, semimembransus, and the long head and short head that collectively are the bicep fen muscle. I have alot of memorizing to do!
Written: 9:00 p.m.

An Off Day

May 11, 2011

Ragged Mountain Physical Therapy is not open today, so I was unable to do anything. That is the reason that I am doing extra hours the other days so that I can make up for the lost time on Wednesdays. However, when I first woke up I did a little studying of the parts of the knee, but the names are all so hard to remember, I am going to have to continue studying.
To fill my time today I first went to breakfast, and headed over to the woodshop for about two hours to finish up my project, which is a cherry queen sized bed. The rest of the day consisted of a team lunch, some free time, watching the boys lacrosse game, my own game in which we lost to holderness by one, a tailgate afterwards and watching the movie Fresh for earthday.
I am excited to get back to work tomorrow after my day off.

Carpal Tunnel and a Leg Amputation

May 10, 2011
Worked 9:00-12:30, 1:30-2:30
This morning was a slower one, but I had the chance to get a head start on my studying of the parts of the knee. I will be quizzed on the bones and muscles in the knee, which is an easier place to start because I know a little something about it from my surgery last year.
The first patient today was one with carpal tunnel from repeatedly scooping cookie dough. The carpal tunnel is in her right hand but the body tends to mirror things and she has it in her left as well. Diane let me do the ultrasound on both hands and she got stim and well as doing her stretches.
Nancy Schoeller was in the office this morning because she often comes in to help Diane answer the phones, so it was fun to catch up with her. The phones were not ringing very much so she got to catch up with her facebooking which she is really into right now.

The other very interesting thing that I got to hear about today was about a man that is having his leg amputated and getting a prosthetic. He is working on strength in both his legs and his arms from a previous injury. I was able to hear about what his exercises consisted of and about a surgery that I had never know first hand of someone having. I came in after lunch to see this one!
A man that had had rotator cuff surgery came in earlier in the day and was doing very well with his range of motion. After warming up, Diane was doing passive range of motion stretching, meaning that she was doing all of the work in order to extend his range of motion.
I had a great day today, learned alot and I look forward to getting back in there Thursday!

10:05 p.m.

The First Day

May 9, 2011
Worked 9:00-12:30
Today was the first day that I worked at Ragged Mountain Physical Therapy. Diane first went over things that I need to remember about blogging, and then we got started. She told me of some things that I could help out with, when I am not observing her with a patient and learning. There was a variety of different injuries today. The first patient that was in had fallen off of his roof and was having back pain, which was irritated more by continual work in which he needed to be bent over. The next patient was one that had been in a car accident 2.5 years ago and had whiplash. The muscles on the back of her neck were very tight, so ultrasound, massage, and heat were all applied mainly to the trapezius muscle. After this patient, a woman that had had a hip replacement came in, and had been doing very well with her recovery. It was an anterior hip replacement, which means the surgeon goes in from the front of the hip and the muscles do not have to be detached. The recovery has caused the patient to have swelling in the knee, and tightness in the IT band. The last patient was new to Diane. She is a runner and has been having calf pain. Because of the feeling that it is deep, the problem is on soleus muscle. Before Diane ultrasounded, massaged, and stimed the calf there was a visible bump on her calf and tightness in the achilles. She was instructed to not go back to running yet, but can do on the bike and needs to stretch the calf a few times a day.
9:10 p.m.