1. "If you are frustrated, the odds are that so is your patient, even more so."
    — Learn to practice with patience and tolerance. Everyone learns and heals at a different pace.
     

  2. New Faces, New Perspectives

    It’s only been two weeks and we are finally picking up the pace in class. This spring quarter was intentionally organized to be significantly easier that winter quarter to create a better segue into summer and our comprehensive exam coming up in august. We have added a couple new courses to the program during this quarter to tag along with the cyclical coursework in neuromuscular, musculoskeletal, and clinical education: Multiple systems, PT Administration, and Geriatrics. Although it may seem like an over the top kind of schedule, there a less hours this quarter spent in the classroom and more time outside of class to work on group projects, quizzes, and homework assignments. On top of it all the weather has been making a turn for the best with the daytime temps extending into the 60’s which has got our class and seemingly everyone on campus very excited to know the cold is now behind us.

    In musculoskeletal we have moved on from the knee and hip and have started covering the SI joint, and just this past week progressed to spinal manipulation with one of the most decorated and knowledgeable orthopedic PT specialists around; Dr. Steve Allen. Due to the recent change of events, physical therapists have finally recaptured the ability to practice spinal manipulation in Washington again. Years ago Washington PTs gave up that privilege while negotiating for the option of obtaining direct access. But in the end we have prevailed in getting that right back with a few stipulations regarding the amount of spinal imaging and manipulation practice. For these reasons we have brought in Steve Allen in to assist in teaching this section of our coursework. It is so nice to be taught by a man with so much knowledge and passion for what he does, yet the humility and modesty of the average man. We will be sure to glean as much as we can in the weeks to come.

    Our Geriatrics class that is held once a week is instructed by one of our adjunct faculty members, Chris Henderson who is an experienced clinician and rehab director over in Olympia at Aegis Therapies. Chris is a bit of a comedian who makes his lectures on dementia and aging engaging and substantial. In his course we are learning the in’s and out’s of geriatric care from the first evaluation all the way to home assessments and modifications for discharge. The past two weeks we have discussed the differences between normal and pathological aging. Because as we age there are some expected consequences to our health but it need to be known where to draw the line between expected detriment and disease related changes in function. This past week we have moved on to one of the larger, more umbrella topics of dementia and cognitive decline. One of my favorite quotes was when he said, “ Its not that the patient was non-compliant with the therapy program, but the therapist was non-compliant with the dementia program”. Wise words and very insightful as to what it is like viewing therapy in the patients perspective.

    Appropriately, this quarter our professor Dr. Russell, who is also the associate dean of the health sciences, is teaching our PT administration course. In this course we have been talking about some of the legalities of PT practice, boundary violations, communication within and between companies/occupations, and marketing a business, because ultimately that is what we will become a part of. Later this quarter we will be dividing up into groups and constructing a business plan for a proposed clinic that includes all the nuances of running a business.

    As a culmination class, our multiple systems course focuses on patients that will come to us with a plethora of pathology that does not fit a single diagnosis code. This course is taught by Dr. Gersh and Dr. Nelson, as well a few guest lecturers that specialize in specific pathology. So far we have lectured on patients with hemophilia and patients with psychological disorders, each presenting with their own clinical difficulties and considerations. This past week we had a comedic guest lecture by Dr. Ron Klein, a clinical psychologist who detailed the in’s and out’s of how to work with patients with a variety of common disorders. He also talked about the difficult topics of sexual inappropriateness and how to redirect and diffusing awkward situations that undoubtedly will happen to all of us at some point in our careers.

    This quarter in our neuromuscular class we have had the luxury of having Dana McPhee come back to help with our Neuro ICU section. So far we have covered ischemic pathology along with spinal cord injury. Specifically we have discussed the different pathologies, varying presentations, diagnostic tests, and medical support equipment. One of the benefits to having Dana is that she is so knowledgeable, current, and experienced in the field that she has the capacity to condense her understanding into a palatable dose that we can make sense of. A true blessing at this point in the curriculum when we are running out of space upstairs.

     

  3. "Its not that the patient is non compliant with therapy program, the PT is non-compliant with the Dementia program"
    — Really great insight from our professor Chris Henderson during his lecture on dementia and cognitive impairments. Ultimately it is incredibly important for us as practitioners to try to practice universal awareness when it comes to our patients so that we can be understanding, empathize and problem solve through difficult situations.
     

  4. "I love my patients to death, but they are liars"
    — Wise words spoken in our Geriatrics class while talking about why to take vitals: Because they cant fake it.
     

  5. Here is another great story of a huge need and a little innovation and creativity.  =)

     

  6. Here is a fun article of the ingenuity of one mom that may have revolutionized parenting children with developmental delays and/or gait deficits.

     

  7. A little Spring in our steps

    I would like to just start by saying that winter quarter was the hardest of any of the previous quarters yet. It let many of us haggard and gasping for air but in the end we all made it to spring break with a limbs attached. The last few weeks have been a whirlwind. With tests culminating, the neverending sicknesses being passed around through the faculty and students, and the seemingly endless amount of lectures, presentations, labs, and assignments… We were ready for it to end. But within those last couple of weeks we were still able to enjoy what school had to offer, especially the ten minute hourly breaks spent outside in the sun that would bless us on only a few occasions. Within the classroom we had some fun as well. We were able to have very comedic lectures by Dr. Palmer’s wife on communication and working with other professionals, as well as Brian Cronin’s wife about overuse injuries in the pediatric population; both with enriching anecdotes of our beloved professors. =) We also got the opportunity to fit one another for a wheel chair as well as try out a variety of different chairs, cushions, and electric mobility devices to give us an idea of what is out there for pediatric and adult patients with spinal cord injuries. Another brain break was our trip to the Hanger prosthetics workshop and clinic where we were given a tour and a Q & A session with Don Meng, a prosthetist that works with Hanger. There we were able to play with a variety of different prostheses, both old and new, and see how the mechanisms for the joints and limbs have evolved to become lighter, stronger, more functional, and more versatile.

    This quarter we capped it off with 5 finals, 3 written exams and 2 practicals. The 2 practicals were for musculoskeletal and cardiopulmonary, and they were both multi-stage practicals requiring diversity in both knowledge and skill covered through the entirety of the quarter. Little to say they were quite difficult to study for, and even more so to take. The written exams were no different, comprehensive and very difficult. But in the end, like all well-oiled machines we banded together in study groups and prevailed over these exams to move one step closer to clinicals.

     

  8. Light at the end of the tunnel

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    Over the past few weeks the weather has been quite bi-polar out here in Spokane. One day we get a foot of snow and the next it is 40 and sunny. But when the weather forecast is unpredictable, our workload sure isn’t. As students in such a rigorous program we are always prepared for the forecast of a 95% chance of difficult with a high probability of stress. But weather aside we have been progressing nicely through the quarter.

    In pediatrics we have had the opportunity to work with more children, applying the expected milestones and certain assessments to the motor skills we observe in the classroom. Last week we had  a 4 year old by with cerebral palsy come into the class. It was lovely to see him walk in with the most vibrant smile on his face, waving at everyone that was gathered around to watch is movement patterns. He had some major speech deficits but was able to understand most of which we asked of him and used some sign language to communicate with his mom. He had a dorsal rhizotomy last year that has allowed him to learn to walk, along with the continuous dedication of his parents and therapist to augment his growth and motor progress. It was interesting to observe his gait and to identify his deviations and speculate based on his pathoanatomy why he has adapted these patterns. Little to say we learned a lot from such a spirited and energetic child. We also had the opportunity to have our classmate Zach’s daughter Kayden join us in lab for a short playtime. She is developing well for an 11 month old child and is always stoked to get to hang out with her extended family =)

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    In Cardiopulmonary we have finally finished up the last two patient cases, totaling 5 very extensive and complex patients that we have had to decipher in teams over the past year and a half. Last week we had our midterm/final exam on the last two cases. It was a tough one but im pretty sure we all came out with confidence and a bit of relief that we are one more final closer to being done with this quarter.  In other news our labs have been focused on acute care scenarios. During these times we have had to decode a myriad of lines, tubes, and apparatuses attached to mock patients, identify suspect lab values, and simulate acute care patients with an array of diagnoses in small groups. For those of us that have not had the chance to observe in the acute care setting, this has been a bit of a shock to the system while we watch our classmates operate like professionals. But that is the beauty of this program. We get the opportunity to highlight our strengths while at the same time teach one another how to improve each others weakness. Its what makes each and everyone of us unique and an elemental part of this program.

    In our integumentary systems course Dr. Gersh has been lecturing on elecro, ionto, and laser therapy and its implications in wound care management. This topic has some of the class a little queasy at times due to the graphic nature of some of the example wounds and treatments. It is the section of the curriculum that is fairly specific and specialized but in the end we will be thankful if by chance we end up switching therapists halfway through one of our internships and getting thrown into a burn unit or paired with a wound specialist. To mix it up a bit we had Carrie Davis come in and guest speak to our class about upper limb prosthetics. Being someone who was born missing part of her left arm, Carrie has incredible insight as to what it is like growing up being different than everyone else. She is also incredibly motivated and passionate about working with children with partial and amputated limbs because she has truly recognized to power of prosthetics and their ability to change the lives of those who wear them.  Carrie also works at Camp No Limits which is a summer camp that is for children with prosthetics. At the camp children get to participate in workshops, adaptive activities and just overall fun-tastic adventures! It is held in july and i know there will be a handful of us that will be applying as volunteers. This would be a great opportunity for us to give back and to learn an incredible amount. Not only was this lecture insightful, but it was also one of the funniest we have had all year. Little to say we could welcome back Carrie any time.

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    In musculoskeletal we have worked down into the lumbar spine evaluation as well as the hip. These portions are structured similar to the other segments of the body that we have already covered. After learning the examination portion of the evaluation we then discuss the different conditions that make up the select preferred practice patterns as outlined by the APTA Guide to Clinical Practice. Along with lecture we also have be completing all of these examination and differential techniques in the lab as well, getting a double dose on Tuesdays and Thursdays. I guess you could say that practice makes perfect, or just entirely stressed out DPT students. Either way we only have a few weeks left until spring break. There is a light at the end of the tunnel…

     

  9. What happens in Vegas, doesn’t stay in Vegas…

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    The past week we had off from class which was a much desired sabbatical from the prior week’s rigorous schedule. But this was not just a free week for most of the class. Over the past year we have worked our butts of fundraising to send our entire class to the annual Combined Sections Meeting hosted by the APTA in Las Vegas.

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    But don’t think that we just partied our pants off with loved ones and friends (although we did that as well), we also attended a variety of presentations, seminars, and poster sessions where presenters from all across the world came to speak on their topics of interests in the physical therapy domain. Emphasis ranged from sports medicine to acute care, and from aquatics to pediatrics. Many of the sessions were worthwhile learning opportunities while others were simply information that we have already extensively covered in our curriculum to date; A benefit of being part of such an awesome program. Aside from the lectures and presentations there were also the two exhibitions halls that were chalked full of new technologies including aquatic treadmills, full body vibration platforms, and electronic body weight suspension systems.

    Along with the exhibitors there were also plenty of opportunities to network with future employers, residency programs, and practicing physical therapists. During our time off from the convention we for the most part broke up in to groups and attended concerts, cirque du solei performances, the bodies exhibit, the new your new york roller coaster, the old vegas, the pawn stars pawn shop, the Bellagio fountain, and of course a little gambling for those daring enough to risk it all. All together it was a nice trip with warm weather and good company. Back on the grind now with a full schedule ahead of us.

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  10. Remedy for your extremity

    The past couple of weeks have just flown by considering we have to cut a week out of this quarter for our visit to Las Vegas this week for CSM hosted by the APTA. Although our program supports us financially to participate in this national collaboration of knowledge they also require us to buckle down and get school work completed before we take off. This past week we had one quiz and two examinations, not counting the practical exam that got postponed until after CSM. Regardless I feel that this made all of us stay on top of our studies during this first part of the quarter which will ultimately pay off when we round the bend for finals.

    Over the past two week we have covered an incredible amount of material in all of our classes. In integumentary we have had a couple gest lectures. The first was a continuation of our amputations unit about prosthetics where we had the opportunity to learn about different types of lower extremity prosthetics and ways in which to serve and engage with patients that have had amputations. Our other lecture was about the diagnosis and management of patients with lymphedema. This lecture was particularly interesting because lymphedema is one of those conditions that can be insidious in nature and is controversial in its treatment. Our guest speaker emphasized the need to incorporate the wellbeing of the entire lymphatic system in order to stimulate facilitate drainage.

    In musculoskeletal we have finished up the hand and have moved on to the ominous lumbar spine, the area of the body where approximately 85% of people will experience pain at some point in their lifetime. In order to prepare for this section we first covered the lower quadrant screening exam which is the equivalent of the one we learned last quarter but for the lower extremity instead of the head, neck and upper extremity.  The screening exam is a critical element of our evaluation because it helps us make sure that our patients are presenting with disorders that we as physical therapists are licensed to treat, and making the proper referrals for suspect pathology.

    In our pediatrics we have been covering a variety of different motor assessments that are typically used in pediatric clinics. We have finally been able to get some children into the classroom to observe and complete assessments on. The children so far have not had any abnormal findings but in the following weeks we will have to opportunity to observe children with atypical development. This past week we had a guest lecture from one of the professors of the Speech and Language Pathology department. It was a very insightful lecture that focused on the development of speech and language during the first critical years of life and how it is impacted by neurological pathology.

    In our clinical education class we had our second interdisciplinary collaboration session with the PTA students from SFCC. During this session we broke up in groups and simulated a clinical evaluation and treatment session with a patient that incurred a TBI. It was quite the sight to see 20 mock patients rolling around in wheelchairs yelling and pretending to have brain injuries. It was a good exercise to have to work through a treatment session with the PTA especially with such a complex patient.

    In cardiopulmonary systems we have been going into greater detail into the case studies that we began last year. This past Friday we had our first exam on those three patient cases that focused primarily on the implications related to their pathology of the heart and lungs.

    But enough already! Off to Vegas!!!