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.