Thursday

Tomorrow is Friday!! I'm excited for the weekend, although I am not looking forward to the 3+ hour drive back to the Cities this weekend. It will be nice to see Ross and some friends, but it would be nice to have another weekend up here, too. My week has gone pretty well. The kids were fairly well behaved this week, although we have been having some problems with one little boy. The current theory is his lack of breakfast (he has a tendency to eat candy during the morning instead). He can be a very cooperative boy, and he has made quite a few gains in PT this year, but there is something else going on. On Wednesday morning, I joined the PTA at the junior high. I usually go to two different elementary schools, but I wanted to experience at least one day with the older kids. It's interesting to think about what the current elementary school students will be like when they get to junior high. The junior high kids have some similar physical issues and some of the same treatment strategies are employed. It was fun to see the treatment progression and how interventions are a mix of "adult" exercises and playing games. At the elementary school level, the kids do some mat exercises, but things are more incorporated into play.

On Tuesday evening I had my first cookie baking experience of the season! The PTA and I made thumbprint cookies and some kind of polish bowtie cookie, and they both turned out pretty amazing. I ate my fill of dough as well. :) The polish cookies are topped with poppyseeds, which is actually really good. We made some with red or green sugar sprinkles instead, and also got creative with shapes. Dozens of bowties would be boring, so we made some candy canes or yule logs or wreaths... Now I just need some shadowbox cookies or almond bars and it will truly be Christmas season.

Today I went to a mini lecture at the Duluth YMCA. A local chiropractor gave a talk about running and treating running injuries. (The Y is trying to start a running club and was hoping this would garner some more interest. I enjoy running--and treadmills are not enjoyable--but finding a large group of people interested in running in hilly Duluth at 7AM when winter mornings are below zero before windchill may be a challenge.) As I have previously mentioned, PTs and chiropractors do not always see eye to eye. This guy was good (in my opinion). He discussed the runner's gait and common bad running habits. He gave tips to avoid improper technique and discussed some of the biomechanics behind the bad and good habits. He then discussed the phases of a runners gait and how those tips matched with the gait. He also demonstrated some basic exercises and stretches to curb injuries in the first place and to self-manage injuries already incurred. I found it interesting, and it meshed with what I have been taught. I wish he had given the talk a few weeks ago because he and a PT do gait analyses two evenings a week in Duluth... but my final week is filling up fast.

A few pictures

Since the written post was so long, I thought I would do a separate one of a few pictures...

The first is of the Aerial Lift bridge in Canal Park (the bridge "slides" up instead of opening like a draw bridge). The bridge is at the end of the ship canal and it leads into the harbor. During the summer when there is a lot of freight traffic, people get stuck for 20 mins plus as a huge barge passes under. My friend Rachel's boyfriend lives on the opposite side of the bridge as Canal Park, and she says it can be a pain to go into Duluth.

The second two pictures are from Enger Park looking out over the harbor and the hillside of Duluth.

The fourth picture is possibly the most gaudy house in Duluth, which I drive past on Tuesdays and Thursdays when I go into the schools. Because of my weekend adventure in Duluth, I saw it lit up in all its glory. For those who are interested, I also took a picture of it with the night setting, so the lights are brighter and all blurred together.

Apparently the pictures loaded in the opposite direction--sorry. The pictures are small, but if you click on them you can view a larger version.

My last weekend in Two Harbors

This past weekend was unfortunately my last in Two Harbors. I really wish I had more time to do things in this area! On Friday, I met up with a PTA from the clinic at her church and helped her paint the backdrop for the Christmas pageant. We ordered pizza and hung out--which was really nice. I met her friend Liz and we had a good low key night. It snowed Friday night (about a few inches) and it was beautiful! Since not too much accumulated, the roads were cleared fairly soon. On Saturday I checked out a craft fair in Two Harbors. I hear that you can usually find a craft fair in this area every weekend from Thanksgiving to Christmas. People are very talented, and if I had more money, I would have spent it. Then it was on to Duluth for me. I met up with my friend Rachel from class for lunch down in Canal Park. We checked out Amazing Grace, which is a cafe/bakery that my first CI recommended. It was really good--and for the record, their sandwiches are huge! Since we were down by the lift bridge, I meandered down there and then checked out some of the stores in Canal Park. During the summer, the area is pretty busy. Some of the stores are rather touristy, and some are more fun and functional. Duluth Pack is an REI-type outdoors store that has some really neat stuff. I then drove up the hill to Enger Park, home of Enger Tower. Enger Tower has a great view of the port and the city, but it was closed for the season. I just got to peer over the scenic overlook, which is not as dramatic. It was nice though. I wish I had gone earlier in my stay here so I could have checked out the view from the tower. I probably would not have had a Statue of Liberty-esque line either.

Sunday was another good day. I was sad that it was my last Sunday at the church I have been attending because everyone is so welcoming and apparently glad to see me. That afternoon, the pastor and some others had a Christmas concert at the local assissted living/nursing home. It was called "The Three Pastors" kind of like "The Three Tenors." So obviously three pastors participated, and then they were joined by various members of their congregations on various instruments. There were some solos, duets, and trios. I really enjoyed it. About a half hour before the concert started, snow began to fall. The concert was in the big open lobby of the assissted living home, and they have a three-sided balcony and a wide staircase. The balcony has lounge chairs, and other chairs were set up as well. The balcony also has several large windows, so I really liked watching the snow while listening to Christmas music. Some of the residents were pretty funny too. I could hear them "whispering" to their hard of hearing neighbors... "Oh, he plays the guitar!" "He's singing in French!" "What is that red box for?" The residents lined up along the balcony railing had quite an impressive collection of rollators/Cadillac walkers (like Grandma Moore had). They seemed to enjoy the concert. And if that wasn't enough Christmas for me, I went straight over to the Baptist church for the Christmas pageant that featured a wonderfully painted backdrop. The play was really good. The kids were really cute and really into singing some of the songs. There are always a few shouters, and this play did not disappoint in that area. The play was called "Hotel Bethlehem" so several travelers arrive and fill up the rooms before Joseph and Mary can come. Then the baby is born and shepherds arrive... and the shephers were two teenage boys and two adults--one of whom is the pastor. They wore sunglasses danced on stage during their song! They did the Night at the Roxbury head nod, some air guitar, and some other moves. The congregation obviously loved it, as did the kids. I wish I could remember some of the other funny events and other funny things that kids did and said. Overall, it was really enjoyable. The cookies and bars afterwards didn't hurt either. :)

I had two evals today in the clinic, and they both went pretty well. I didn't do much with the second. The man has some severe cognitive deficits, and he had a painful fall onto his hip. His caregivers said they had never seen him cry before, and his gait completely changed after the incident. He also resisted doing stairs. Because he was agitated and nervous with the new situation in PT, we thought it would be best for my CI to take the lead so he would have fewer people to deal with. After the interview with him and his caregiver, Sara did a muscle energy technique with his sacroiliac joint (using the strength of the patient to make minor changes in bony alignment) and he improved! His walking went back to his normal. It was kind of neat to see, and to experience how to perform an eval on a cognitively impaired adult that cannot communicate verbally.

My other exciting event today was ice skating! While treating a patient (high school cross country skiier), I mentioned that I had ice skates in my trunk and that I was hoping to do that before I left northern MN. When I was charting at the end of the day, he stopped by the office after practice to let me know that the final open skate at the arena before December 21 was tonight from 6:45-7:45. I was so excited that he stopped by, because I probably would not have checked in enough time to go tonight. So I skated and had a great time. I did fall once when I ran into an elementary school aged boy (who stayed on his feet), and he was very apologetic and helped me get back on my feet. I told him it was more my fault than his. I felt a little dumb, but it was pretty obvious that I was not skating near as well as the other people at the rink. Anyway, I have probably babbled enough for this entry. Hopefully it will help make up for all the days I didn't update...

My Week

I again did not do a great job of updating the blog throughout the week... time just seems to get away from me. I had a good week in the clinic and was able to see more patients myself--which is a good feeling. I still am asking questions and not quite sure of everything, but I am learning. I don't think I saw anything super remarkable in the clinic, but my total knee replacement patient has not cried for the past two sessions, so she is on the mend. The ACL patient has gained some range of motion and confidence. The kids were pretty well behaved at school, though we did have some talks about listening. One little guy with autism has made some gains in the past couple of weeks. He still does not follow all directions, but he has started to catch and throw hula hoops on their sides--which is huge because he has no natural catch reaction. He even was hitting a ball more consistently with the hockey stick. I am really intrigued by him and his sensory needs. I wish I could just get inside his brain as an observer to see what is going on. He has some obvious issues with typical communication, but is able to understand verbalizations. He also is rather affectionate and likes to be touched, which is not always the case. Hopefully we can get him to pay attention long enough to do an obstacle course.

On Wednesday afternoons, I try to go up to the high school with one of the PTs to see any athletes that may be injured. The school does not have the budget to hire an athletic trainer, so the PT serves as a volunteer screener to provide simple exercises or appropriate referrals. This week we had a freshman hockey player (I forget how little ninth grade boys can be!) with a groin injury. He was easily able to identify motions that caused pain and the specific play that led to the injury. He was willing to try different stretches and activities to try to reproduce the pain so we could properly identify the tissue causing his pain. When we palpated him, he told Heather to go up farther and "righter," which I liked. His pain didn't follow an easily identifiable pattern, but we worked through it and I helped identify what it was! I was a bit unsure of how to procede at first, but once Heather got going, it became more natural for me, which was encouraging. So if anyone cares, we think he strained his adductor magnus.

On Tuesday evening I went on a $1000 shopping spree! The pastor, his wife, and another church member received a $1000 gift card from Pamida (like a K-Mart) to buy toys for the Salvation Army "store" in the church basement. Parents get to spend 25 points per child, and the toys are assigned an appropriate point value. It was pretty fun to play with the toys and pick some out and load the 6-7 shopping carts... the check out people, however, didn't think it was as fun as we did. :) It's amazing how fast you can spend $1000. I think they actually have about $80 left, plus additional gift cards donated by shoppers.

On Thursday I stayed in Duluth for Thursday Night TV Night at one of the PTA's houses. It was pretty fun. We ran some errands, made supper and dessert, and talked and watched some TV and some Wii. Some of the PTA's friends came over with their kids, so we were entertained by some 9 month olds and an 8 year old. Since we had the Wii Fit going, we watched less TV and more of us being labled "unbalanced" by the game system. I have only played the Wii a few times, and I have managed to not improve. It was a good evening.

December already

I can't believe it's December already! Thanksgiving has come and gone... and now it is time to countdown until Christmas. I had an enjoyable Christmas with Ross and his family in the Willmar, MN area. We had a lot of good food, played some Catch Phrase, and talked. Ross's cousin recently adopted an 18 month old girl, so she was the focus of attention. She is really cute. I tried to get her to do the "so big" thing, but she wouldn't have it.

I worked the rest of the Thanksgiving weekend (which kept me out of the stores for a good chunk of the shopping madness) and Ross and I worked on some wedding stuff. I also met a friend for supper on Saturday, so I had a successful weekend. I drove back to Two Harbors on Sunday afternoon and arrived back in time to catch a majority of the combined churches Advent service. Each participating church had a choir/ensemble that performed a song, followed by a reading, and a congregational song. Two Harbors has a good number of churches considering it only has about three to four thousand people. The churches are not big, so the ensembles ranged from about 3 to 15 people. A handbell group from a church in Knife River (a neighboring community) also participated--and that was really impressive. It was not the most technically precise of handbell music, but they had only six people and twelve bells, so to hear them play the "Gloria" from "Angels We Have Heard on High" was really neat. I loved it. The service ended with a combined chorus singing Handel's "Hallelujah Chorus." I am so glad that I was able to make it to most of the service. I miss going to church on Sundays when I work and then drive back to Two Harbors--and there is something special about church during Advent. After the service, they served bars, cookies, and coffee in the church basement. I ate some excellent Minnesota bars and sat with some nice older ladies. I felt like an anomoly at the table, but then a middle aged lady joined us, so I didn't feel so out of place. I found out that she is a social worker who works with some kids at one of the schools that I go to for PT. I guess I shouldn't be surprised at how small the world is in Two Harbors...

This week looks like it should be a "normal" one in the clinic. I am hoping to increase my patient load and be more independent. I am learning a lot of good exercises and tricks for knee patients, and I am really enjoying that. I can't believe that I only have three weeks left at Bodies in Balance! I hope to learn a lot in these last weeks and really put things together with better mental organization.

pre-Thanksgiving

So I cannot believe that Thanksgiving is nearly here! My time in Two Harbors is going by so quickly... I am looking forward to celebrating Thanksgiving as there is always a lot for which to be thankful. The pumpkin or pecan pie doesn't hurt either. :)

This week in my PT life won't be too much out of the ordinary. Today I helped out with a pool treatment for a little guy. He did well with the swimming and kickboard activities initially, but then had some behavior issues. He likes to sit in the sauna (not on) when he becomes overstimulated, but it was not available today. We thought he was tired and then too focused on the sauna, so he ended a little early today.

I am able to take over more of a patient load in the clinic, so that is exciting. I am still a little limited by Medicare guidelines, but we are finding patients that I can treat. The best part of it all (in my mind anyway) is that one of my patients is post-op a total knee replacement--and she has sutures that need to be removed! So on Wednesday I get to remove sutures in the clinic along with my CI. Tomorrow should be a "normal" day in the schools, and I am hoping that the kids aren't too ramped up for Thanksgiving break. I spent less time with the kids last week because of the various evals and meetings, so I am looking forward to participating more in the treatment. One of the kids has made some good progress in following directions and trying new gross motor skills, so that's been exciting.

This is a bit early, but Happy Thanksgiving!

A hectic week...

I know it is only Wednesday, but I feel like this week has been crazy... I have done quite a bit of driving around, which is probably contributing to that. I've had some great opportunities within the schools (hence the driving) to participate in IEP/eval meetings and various testing procedures. I was able to do more testing with the BOT and the Peabody. Tomorrow I have another IEP/eval meeting. At the eval meeting on Tuesday, I was able to speak with the parents regarding the results of their son's gross motor testing. I really enjoyed being able to participate on that level. It was also fascinating to listen to the other professionals and what their testing and observations had shown. I am glad I picked PT as my profession, but sometimes I really like the sensory world of OT. The little guy discussed on Tuesday has some significant visual issues and has difficulty tracking objects and paying attention in a visually stimulating environment. He does some work with the Minnesota Vision Institute (or something like that) in the Cities, and I liked hearing about his exercises that he does to improve his vision. Poor vision can easily contribute to poor gross motor skills, and learning about those deficits helped explain what we found in PT. Today I stopped in the special ed classroom to pick up another boy for the Peabody testing, and the boy discussed on Tuesday saw me and got all excited because he wants the PT and I to come for him. Then he had to ammend his statement and say that we had to come next week because he would be gone tomorrow. And that is why I like working with kids. Ask me again tomorrow, though because behavior can change that statement...

As for life in the clinic, I have done a few more evals and have taken a few more patients on my caseload. Some of that was interrupted with the running around for the school evals and meetings, but hopefully I can pick that up again on Friday and next week. I can't believe that I have only one more month left up in Two Harbors! It's gone by quickly. I feel like I am learning a lot and now I just have to reinforce it with studying at home. Unfortunately things like updating my blog interrupt those plans... One of the patients that I will hopefully be treating is post knee replacement, so it's interesting to see a patient starting outpatient PT for treatment because I deal with a lot of knee replacement patients at the hospital on the weekends.

Glensheen

Today I toured the Glensheen Mansion in Duluth. It was owned by the Congdon family and was built in the early 1900s. After graduating from college, Chester Congdon passed the Minnesota bar without attending law school and then made a series of wise investments (many involving mining, but one included some land in the Yakima Valley in Washington, and that orchard now makes Tree Top apple juice). He had Glensheen built for his family--and the house is pretty incredible. It's ornate and somewhat lavishly decorated, but it is not overdone. I think there's something like 39 rooms in the house, and it was wired for electricity before electricity was common, and it also had a central vacuum. The house and the family were well known in the Duluth and Minneapolis/St. Paul areas, but they became nationally known after the 1977 murder of heiress Elisabeth Congdon and her nurse. Apparently Elisabeth's daughter is back on trial again now, but I do not know the reason for the current trial. I do not know too much about the murders, the trials, etc, but I am reading a book about the crime. I am only about 40 pages into the 400+ page book, but I am glad I had some of that background before touring the house. The crime is not the main focus of the tour; instead the tour highlights the elaborately designed home and the people who lived there. Only recently were the tour guides even allowed to discuss the murders. So some of the tile used in one room was $5 a square in about 1905, some of the wood was specially fumed with ammonia to retain its color, and various other wallpapers, woods, lamps, vases, etc. were imported from around the world. It was an expensive home to build in the early 1900s, and would have cost millions today. Unfortunately they do not allow pictures to be taken inside the house, but I was able to get some of the outside. The house is built on the shore of Lake Superior, just north and west of downtown Duluth, and right along London Road/Highway 61 which heads north to Two Harbors. I am including a picture of the view from the lakefront, the front of the house, and the back of the house. I did not take any pictures of the grounds, but the Congdons had extensive plant and vegetable gardens (including greenhouses that grew tropical fruit, but they have since been torn down), a tennis court, decks/patios, a fountain, a boat house, bridges over the creek, and a carriage house. I think all of that would have been more impressive during the summer when everything was in bloom. Anyway, the tour was interesting, and I am looking forward to reading more about the house, family, and crime in the book.

Another Wednesday

Today was a pretty good day... I did my first BOT-2 test (evaluation of motor skills for kids), and it went pretty well. The PT I was with was really helpful in providing tips as to how to better administer the test and note how kids "cheat" to perform the task better. She also showed me some good ways to get kids to perform skills that use similar muscle groups but may not be as challenging as the test. The alternatives are good to document what the kids can actually do to pinpoint which area is the hardest for them. The kids I worked with today were good at cooperating and staying on task (even with the lunch time traffic in the school). Tomorrow may be a bit of a different story: the evals are on 2 boys with a history of running/darting through any doorway they see. The teachers at the schools advised us to have as many people on hand as possible to guard the doors... luckily we will have me, a PT, and a PTA. One of the boys was even seen throwing the cards he was supposed to shuffle in a manual dexterity task for the OT.

On Tuesday I went running down along the Lakewalk in Duluth again. This time I had no creepy runners with me. I took a couple of pictures from Lakewalk East where I started running toward Canal Park. I think they are a bit blurry, but in one of them you can see the bridge over to the Wisconsin side of the lake. The taller bridge is the aerial lift bridge, which is kind of the symbol of Duluth (as far as I can gather). It appears in a lot of postcards and brochures. I think it's supposed to be snowy/rainy tomorrow, but if the weather cooperates, I might try and do one last run down by Lake Superior.

I just looked at the pictures, and I think they are too small to really get the details--but it looked cool in real life.

Oops

So I have been neglecting my blog as of late... Nothing too exciting has happened up in the Northland, and I was back in the cities this weekend. It was wonderful to see Ross and his family, and I had pretty good days at work too.

Last Thursday I did okay at trying to get a little guy with autism to do a jumping jack, but I think he just didn't want to do it. We might try again tomorrow--and we'll probably play a bit of floor hockey too. We played some musical chairs with some other boys and had scooter races with the girls in the afternoon. Since it was rainy, we had to pull out the indoor tricks... and I have a feeling that a majority of the school PT will be indoors for the rest of my affil. Considering it's now November, I guess that isn't bad. Now I want to get the game Twister because so many of the kids struggle with balance or core strength or coordination. This week I'll be able to do a few evaluations of students using the BOT-2 test. The test evaluates age appropriate activities in categories like bilateral coordination, strength, speed and agility, etc. I've only administered portions of the BOT so far, so I'm looking forward to doing a full one.

As for clinic patients... things just keep getting more interesting. We have a couple "textbook" cases of weakness or typical patterns of post-surgical progression, but some of the patients are fascinatingly non-textbook. It's really causing me to think and actually want to review and study material from my classes! I cannot remember near the amount of information that I want to. So I should probably be doing that now...

Thunderstorm!

Two Harbors is having a great thunderstorm right now... I left some of my blinds open so I can watch the lightening. It is pouring, and has been for quite a while now. I love listening to the rain with the interruptions of thunder. Now is when I wish I could stand outside on a covered porch to watch the storm like Tracy, Ang, and I would do in St. Paul.

Earlier today I was introduced to a different kind of thunderstorm. The PTA that I am with at the schools took me to a bakery in Duluth that makes AMAZING cookies. I sampled the chocolate chip in the store and was surprised at how good it was. When the PTA worked at NovaCare (outpatient orthopedic PT clinic) in Duluth, they would take turns going to the bakery at lunch at random and buying the Thunder cookies (peanut butter with chocolate chips) and then calling their friends and asking if they were ready for a "Thunderstorm." We got some macaroon cookies in addition to the Thunder cookies, and I am definitely ready for a trip back. I almost stopped again on my way home today!

After my PT day was done, I drove to the Lakewalk along Lake Superior in Duluth and ran there. I don't know why I didn't think to do that before now. Today was beautiful until about 3:00pm when it started to get overcast. The rain didn't start until about 4:30. So I ran along the Lakewalk towards Canal Park in Duluth, and it was great. A fellow runner kind of creeped me out a bit, but I still enjoyed myself. It was kind of cool seeing the aerial lift bridge get bigger and bigger as I got closer. I ran out to the little lighthouse along the ship canal and back to my starting point. I'd love to do that again on Thursday, but I think the forecast is calling for more rain and thunderstorms...

Nothing too spectacular happened today at the schools. The kids were pretty good, and we were outside quite a bit because the weather was so nice. I saw multiple kids out at recess wearing just shorts at t-shirts! Pediatric PT is fun because we get to be outside traipsing through the woods or hunting for agates along a gravel road. One of the schools is next to a nature preserve, so we go for walks in the woods sometimes and use logs as balance beams and lift branches for arm strengthening. The difference between typically developing kids and kids with delay is sometimes really evident. One of the boys is in 2nd or 3rd grade and cannot jump off a platform 6-8" above the ground. He has some extreme fear regarding his body position in space and doesn't even like to step over branches or rocks. Others exhibit immature running patterns or have problems hopping. (I might have written about this already, sorry.) We play football with one of the boys and then have challenging touchdown dances involving hopping or jumping or bilateral coordination. It's fun thinking of what to do to challenge them but make it somewhat fun at the same time. The challenge for Thursday this week will be to get a boy with autism to do push-ups and jumping jacks. He has some significant sensory issues and does not talk. He can follow directions and understands spoken communication, and will sometimes model behavior. But one of his "things" is to close his eyes tight--which is not conducive for demonstration.

The storm has stopped for the time being.

PS-If you are a facebook friend, I uploaded more Gooseberry/Split Rock pictures to that site.

North Shore Adventures

Today I took a small trip up the North Shore to Gooseberry Falls and Split Rock Lighthouse. It was another gorgeous day... and nice days should really be enjoyed at this time of the year. I walked a few trails at both state parks. I don't think I truly went hiking because I was on paved trails for part of the time, but I did do some climbing on boulders and rocks along the shore of Lake Superior near the lighthouse.

I uploaded some pictures of the falls, me with a CCC worker statue, and some of the lighthouse. And I can't seem to figure out how to get the pictures to be horizontal instead of vertical, so I uploaded less than I wanted to...

A funny story

I always ask my teacher friends to tell me the funny things their students say or the funny things that happen during class. I am really hoping that I have some good stories after my work with the kids at the charter schools in Duluth. So far I have one somewhat funny story. We were on the swings (as happens frequently on sunny days) with a student. Two sidenotes: 1) Swings are a great place to strengthen core and extremity muscles, and 2) I am surprised that both schools I go to have swings because they can be a big liability issue. Anyway, the student and I were "racing" to see who could swing the highest the fastest. The kids always know who is winning, and I remember those days. As the student and I were racing to the maximum height allowed by the swingset, he noticed we were swinging at the same pace and shouted, "Miss Lisa! We're married!" I had completely forgotten about that occurring on swings, and I was surprised that kids still said that. It made me laugh. I don't think we were "married" today. It is kind of amazing the difference in the gross motor skills of "normal" kids and kids with delays. Some have a really hard time motor planning jumping jacks, others cannot hop or skip or gallop. They do know what tasks are hard for them and will do everything to avoid performing them.

I am posting some pictures from driving along the Scenic Highway on Tuesday and from the sunset yesterday. (Today I ran along the lake for a bit in shorts and a t-shirt!)

Wednesday update

Although Monday's weather served as a warning of things to come, this week has turned out to be really nice. It was sunny both today and yesterday, and tomorrow could possibly hit 60. When I drove from Duluth to Two Harbors after my day at the charter schools on Tuesday, I drove along the scenic highway. It parallels the expressway I usually drive but it runs closer to Lake Superior. It was gorgeous--the water was so blue. I took a couple pictures, but they just don't do it justice. I might try posting some of them later.

I was hoping to get outside today after I was done at the clinic, but I ended up being at the clinic for about 2 hours after our last patient was scheduled to be done. The last patient has a very interesting and complicated presentation. She initially presented as someone with a disc problem in her low back, but now it looks like she could have some kind of hip or sacroiliac joint dysfunction. Her pain location is consistent, but she also has related neck and shoulder pain... we did quite a bit of testing and tried various things to relieve her pain. To add to the complication, she was injured at work and has the workers compensation system to deal with. We tried some functional tasks with her, but she is so weak in her lower abdominal muscles that she cannot support her back and lift or carry items. It's been really interesting and somewhat of a clinic-wide puzzle. I hope some of that made sense.

Other than that, I don't have too much to report. I have been able to take over some patients and increase my participation in patient care, so that has been good. Now I suppose I will return to watching the World Series...

And so it begins...

This morning as I went out to my car to head to the clinic, I realized it is now the time of year where I need to get up earlier in order to leave me enough time to warm up my car. Last night it rained and then froze, so all four doors of my car were frozen shut this morning. Usually only two of the doors will freeze shut depending upon the direction of the wind, but I guess this is my introduction to life on the Northshore... and it's still only October!

Today I attended two info/marketing sessions with a PT at an elementary school. We (meaning mostly "she") talked with the kids in the class in the morning about what a PT does and also had to redirect them back to physical therapy because they went off on tangets about carnivals and Halloween costumes. We did a few activities with the kids and could target a few kids that might warrant watching over the course of this school year because of possible motor delays. It's amazing how you can get a picture of development through hopping, jumping, and bear walking. Then tonight I went back to the school for an early childhood family education event and talked with the parents about posture and positioning for babies to encourage muscle development. It was interesting. The PT also addressed strengthening for the parents and how to incorporate strengthening exercises into daily life (ie. squatting while holding a child, lifting the child into the air, slowing down stair climbing).

In the clinic today, I saw taping for patellofemoral pain, a few patients with shoulder problems, a patient with some lymph swelling after removal of cancer, and an interesting case of hip pain. I wish my brain was better organized to keep up with it all, but it is a learning process.

The pictures

I realized that I did not put any captions with the pictures...
The first one is of the lighthouse on the point between the two harbors of Two Harbors. The next two are of the northern harbor (Burlington Bay I think), and the last picture is looking over Agate Bay, the southern harbor. I learned that Agate Bay is actually deeper than the harbor in Duluth. Ships that load in Duluth often complete the filling of their holds in Two Harbors where there is less risk of scraping bottom. There's a little museum/historical society down by the docks, so maybe I can learn more about the whole process some day. When Ross and Adam and I were down by the docks last weekend when I moved up here, we saw the Arthur M. Anderson pull out into Lake Superior. That ship is famous because it communicated with the Edmund Fitzgerald, a ship that sank in Lake Superior years ago--but no one knows why. Adam told me about the two main theories involving water getting into the cargo holds, but I can't remember the details. Ross maintains it sank due to aliens and can even sing a song about the sinking of the ship. No bodies have been recovered from the sinking because the lake is so cold that bodies sink; Lake Superior does not give up her dead.
And on that note, it is time for me to do some review for tomorrow.

Thursday

So I am not good at updating this blog thing, but I will try. Today was another school PT day for me (Tues and Thurs)--and today was a bit crazy. When the PTA and I arrived at the school, there were several kids and teachers outside the classrooms having conversations regarding appropriate behavior. One kid was even rolling around on the ground. I guess we should have realized from the beginning that today would not be a good listening day. The first boy was out sick, so we were able to delay the inevitable. The next two boys were off the wall--kicking any equipment within reach, running around, not listening to directions--and in no way ready to be assessed with part of the BOT-2. The afternoon kids were also a bit hard to control, but could be somewhat reined in.

Yesterday was a good day at the clinic. On Wednesdays, I'll accompany one of the PTs up to the high school. The school has had budget cuts and cannot afford an athletic trainer, so the PT volunteers her time. Athletes can come in to get injuries checked on, and some may then request a doctor's orders for PT at the clinic. This week was the beginning of playoffs, so no one wants to be injured. The only kid that showed up wanted a basketball out of the bin in the training room. Earlier in the day, we met with another chiropractor in town (interesting in and of itself because of the distrust and competition between the professions) regarding a possible working relationship. The chiropractor has her undergrad in athletic training, masters in PT (though she never took the test to become licensed) and then she got her doctor of chiropractic. Along the way she picked up two other bachelors degrees and is working on a diplomat (chiro certification) in pediatrics and has plans to pursue a diplomat in nutrition. I felt increasingly unmotivated as I listened to her. She had some nice equipment in her office, like an x-ray machine and a foot scanner to make soft orthotics. The foot scanning part was my favorite, but I am still a bit wary of it. I had no idea that chiropractors are required to have the same rotations as MDs... she told us about her OB-GYN rotation and her surgical rotation. I guess they have additional radiology beyond what the MDs have. It was a very informative lunch hour.

I took some pictures today of the two harbors of Two Harbors, so hopefully I can figure out how to get them loaded. And then hopefully I will be better at updating this blog.

Why not....

I recently acquired an ipod (from Ross) so now that I have finally joined that crowd, I figured I should also start blogging.

I am currently living in Two Harbors, MN, while on a clinical at Bodies in Balance. It's an outpatient clinic that also contracts with charter schools in Duluth, so I should have a nice variety in the patients that I see. The therapists do a lot of manual work and the clinic also has a gym. The clinic is private, so they have designated one hour for treatment time--which is not common in the outpatient ortho world.

Today I met a guy that I swear is right out of Garrison Keillor's "Lake Wobegon." I think HIPAA does not want me to give you his name, but he is an older, hilarious Norweigian man with a brogue. I also sat in on a meeting with a chiropractor--which is interesting because PTs and chiropractors are kind of taught to mistrust one another. The PTs and the chiropractor are trying to establish a good working relationship to encourage referrals and address the needs of patients that could benefit from both services.

And now because I can't really seem to get motivated to do anything before 11pm when I want to be in bed, I should really go to bed. Tomorrow it is off to the schools, and then maybe a run near Lake Superior in the evening...