Friday, February 17, 2017

Week 2

Hello again!

To start, I will include my question I used to guide my second week of research: what role does the surgeon play in the formation of post-operative patients' rehabilitation?

This week was the first week in the new location. While there is still some construction occurring on the second level, the downstairs is completely finished and functional. Unlike what I had previously expected, there is still the same "inside"/"outside" divide between the facilities, with the treatment tables inside and the work-out equipment outside. A new addition is the courts which are used by club teams, but the patients definitely use them for specific exercises such as lunges and running. Here is a (fairly low quality) picture of the new site!




Out of site on the right hand side are where the treatment tables are. Again, this is where patients can receive restorative treatments. One of the most used is the game ready, a sort of localized ice bath, where a control unit and body wrap (either shoulder, knee, or ankle) are used to activate air compression and cooling in order to draw heat away from the injury and stimulate healing. While most of the patients receive some type of ice packs, I did notice that a large number of the Anterior Cruciate Ligament (ACL) repair patients used the game ready instead.

With my second week, I was beginning to understand what was happening at my site more. The physical therapists' shorthand for specific exercises on patient charts were actually interpretable and I felt like I knew my way around both the "inside" and "outside" facilities. Because of this, my new question was slightly more specific. I noticed many of the patients were in PT for hip or knee surgeries, and I began wondering how the surgeon-therapist interaction impacted the therapist-patient one. After seeing some charts for ACL and hip surgery patients, I saw that a few had several extra pages stapled to the back from the surgery office with deadlines and goals to meet post-operation. I also picked up a sheet that had a basic description of post-opertive knee exercises. After seeing these two things I felt pretty accomplished, and a little like this:


While the relationship the surgeon has with the rehabilitation protocol isn't as direct as the physical therapist and techs', there is definitely a large influence on how the therapy should be executed and on what schedule. For knee and hip injuries, this definitely seems to limit the individuation at the expense of time efficiency, but the PTs still have flexibility to add extra work-outs or reparative treatments they believe will benefit the patients most based on their age, mobility, etc.

I'm very excited for the upcoming week and what else I will be able to discover about knee/hip injuries and the therapist-patient relationship!

22 comments:

  1. I'm lucky enough to have never had surgery (I probably just jinxed myself), so I don't really know how all this works. Is the patient still having semi-regular meetings with the surgeon to assess their progress, or is all this done by/through the physical therapist?

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    1. Hi Nicole! I´m on the same never-had-surgery page as you, but based on the extra sheet that was stapled to some patients physical therapy charts, it appears that they go back for regular appointments with their surgeons every few weeks or months depending on the severity of the injury and their progress.

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  2. This week sounded like a great week for the project. I do not really not much about physical therapy or surgery, but both of these things sound very interesting in the context of this project. It is very interesting to get an idea of the different types of interactions that occur at the site, and how each type of interaction has its own importance and role. Can't wait to see how this project develops more in the upcoming weeks.

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    1. Hi Sara! I've been realizing just how many different interactions occur in the physical therapy office. Learning more about the field and the patients has been very interesting and rewarding.

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  3. I am not very familiar with surgery myself but I do find it very interesting and especially how it relates with physical therapy. I like the descriptions on the setting and all the interactions that happen in this environment. Between patients and surgeons, how often do they have scheduled meetings aside from with a physical therapist? I'm excited to read more about this project.

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    1. Hi Siena, I'm not 100% sure, but I believe it varies patient to patient based on injury severity and the therapist's opinion of their recovery. However, I think it's normally monthly for the first few months and then moves to be every several months.

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  4. This week sounded interesting with the new building and all. On a daily basis, are there more older patients than younger ones or is it the other way around? How long does a patient usually use the game ready and what are the patient's reactions to the treatment? Can't wait to see your progress!

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    1. Hi Lekha! In the mornings, most of the patients are older, but in the afternoons (after school time) a lot of the patient are highschool-aged athletes. Almost all the patients enjoy using the game ready, and it runs for either 10 or 15 minutes.

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  5. The new building must be pretty exciting! Are there more surgeries for younger or older people that require surgery after? I'm excited to learn more!

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    1. Hey Nikita. What I've seen so far is that there are many older patients with ACL surgeries and knee/hip replacements. As for the younger patients, those who are post-op are normally in for ACL surgery.

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  6. Glad to hear that the new building doesn't have any problems!

    What kind of shorthand was used by the physical therapists shorthand for specific exercises, and what in particular made them understandable. Is it possible that someone without any knowledge on those exercises could understand them, or do you need some background information to get it?

    Good luck on Week 3!

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    1. A lot of the short hand is like SL (single leg) or BFR (blood flow restriction) for exercises and RTC (rotator cuff) for injuries. Personally, I was pretty confused on the shorthand and needed some explanation before I could understand!

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  7. Hello Carla! You said that surgeons have a big influence on a patient's recovery schedule. When do surgeons expect patients to finish physical therapy? Also how much does physical therapy typically cost? And are the people who need physical therapy usually able to afford it?

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    1. Depending on the injury, the recovery time varies. Based on what I saw, a lot of recovery times range from 6 to 18 months until the patient can return to their original performance level. I'm not sure about the pricing, but I know there are many insurance companies that cover a certain number of appointments (ie the patient is allowed 20 covered appointments).

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  8. Wow, the new building looks really cool! And I'm glad to see that the dog gifs have returned this week. As you were talking about the surgeon's role in rehabilitation, I was wondering if you could provide an example as to how a surgeon influences how the therapy should be executed.

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    1. Hi Nathan! Some surgeons provide protocols that they want the physical therapists to follow. Others just trust the therapists' opinions.

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  9. Hi Carla. The new building looks great and I enjoyed reading about your progress and observations on the patient recovery schedules and protocols. Typically, how involved are the surgeons in the patient's therapy schedule? I look forward to hearing more next week.

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    1. Many of the surgeons who are referring patients to CAP are less involved as they already have a set, trusting relationship with the therapists and what they will be doing.

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  10. Hi Carla, I love your Corgy videos. Have you considered adding surgery as a factor in your research question?

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    1. Yes! I was considering possibly observing an ACL repair surgery to see the operative process before the therapy.

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  11. Another interesting post, but the best part may be the dog gifs!! I would love to know smore more about the specifc protocals and recovery schedules that ACL patients may have to go through. Also, would you be able to cover (even if lightly) about rehabs for animals?

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    1. Hi Tsugumi! I'm not sure that CAP has any therapy programs for animals, but I'm sure that there are many similarities between the two types.

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