A Mankato Weekend

I spent this past weekend in Mankato--and that's a first since I have been living here. Ross drove down for the weekend, so that was really nice. We spent Friday evening at the MSU/U of M hockey game. Both schools play division 1 hockey, but the U of M has a very strong tradition of beating MSU. We had standing room only tickets in the packed arena (we being Ross, myself, and some of his army buddies)... and the U of M proceded to lose quite soundly. We stood next to a younger brother of one of the U of M players, and that was kind of fun. The kid was really into the game and he yelled at the players some. His brother was on the ice for one of the U of M goals. (I'm pretty sure the final score was 6-2.) We almost had a fight break out in the stands next to us. A middle aged Gopher fan started yelling at an MSU student for grouping all Gopher fans together as the type to throw items onto the ice... it was rather ridiculous, and we wondered who the mature person in the argument should have been. Despite the unfortunate outcome, it was fun to be at the game. (Sidenote: the Gophers also lost on Saturday even though they played MSU at Mariucci Arena in Minneapolis. I think that's the first time that MSU swept the U of M, but I could be wrong.)

On Saturday, Ross and I went snowshoeing! It was only our second time going, and first time this winter. The owners of the PT clinic that I "work" at recommended a park to me, and Ross and I loved it. The park is only a few miles outside of Mankato, and it runs along the Minnesota River. The trails were nice, but then we ventured off and had some really nice non-packed snow. My lower legs were sore at the end from lifting the snowshoes, but it was definitely worth it. We saw an eagle on our way to the park, but didn't see any other wildlife. We ventured out onto the frozen river and trekked on it for a ways. We did hear one crack in the ice while on the river. The temperature was above freezing, but it was only the second or third with temps above 32 since the beginning of December, so we weren't too concerned. After about an hour, we headed back into Mankato and to the malls to look at some bridesmaid dresses... and a John Deere toy store. In the evening we made soup with one of Ross's army buddies, watched the dismal end of the hockey game, and saw the movie Defiance.

On Sunday, Ross and I went to the church that is essentially in my backyard. My classmate's dad works there, and the church members were excited to find out that I am living with her family. The ladies that talked with us were really nice and welcoming. The church is a more traditional Lutheran one. I was hoping to use the green hymnals I remember from my Faith Lutheran School days, but it just wasn't to be. The afternoon was spent with wedding plans and relaxing, and counting down to the SuperBowl. We went back to Ross's friend's house for the game, and ate some good food, watched a good game, and some good commercials. It was really fun spending time with Ross's friend Nate and getting to know his roommates and some other friends.

So the weekend wasn't anything overly amazing or exciting, but it was great to relax and NOT WORK! This coming weekend should also be a good one--I'll be in California with family before heading to Las Vegas on Monday for a physical therapy conference. This will be my first trip to Vegas, so I am really looking forward to it. Seeing family before is a definite bonus to the trip, and I also hope to have some beach time in the sun.

from Mankato

Things are continuing to go well for me in Mankato--despite the weather! The lows without windchill have been in the -20s, and last night a record low was tied. I think it's a bit ridiculous, but it is supposed to hit 10 above zero tomorrow for a high, so we will have a heat wave.

I haven't done too much exploring around the Mankato area. I've driven in the old downtown area, which would be fun to see. I've visited a couple doctors offices (with the PTs for marketing) and been to the grocery store and Walmart. I am hoping that someday I can have something more exciting to report on the blog someday.

PT clinic life is going well. I am accumulating my own patient load and working on my eval skills. When we are slow (or have multiple patients cancel because of the extreme cold and some icy roads), the PTs and I practice skills. I feel a lot better about some of my manual skills and special tests and am hoping to learn more strategies typically learned in continuing ed, not the traditional school classroom. We have had some interesting patients of late. We have had two older men--in their 80s--who have some balance and falls issues. One of them probably needs a neuro consult, and the other had a partial hip replacement and his recovery is complicated by dementia. We also had an adult with Down Syndrome complaining of symptoms that are not necessarily appropriate for PT, but it is hard to tell which symptoms she is actually having because of communication and cognitive difficulties. It is all very eye opening. I have eval'd a few patients with low back pain, and one of them was a textbook disk displacement. It's rare that things present in the "typical" fashion. Working with a few patients with partial knee replacements or repairs has been kind of fun. It's interesting to compare the different progressions patients have depending on their personality types and complicating factors.

And on a completely different note, I ordered my wedding dress today!

Whoops

Looking back at previous posts, I thought I had ignored my blog when I didn't update for a week... so this is pretty bad! My last week at the clinic up north was a bit out of the ordinary... I dealt with some crazy winter weather, lived in Duluth instead of Two Harbors, and missed 1.5 days in the clinic! Then it was back to the Twin Cities to work, off to Michigan for Christmas, and then to Washington for New Years, a belated Christmas, and a wedding! I had a wonderful (emphasis on the "full") Christmas break. Then last weekend, Ross and I drove down to Iowa so I could see my Grandma for her birthday and he could go to drill. (Sidenote--he only has three drills left!)

Now I am in Mankato, MN, which is about 1.5 hours southwest of the Twin Cities. It's a nice town and home to MSU. I "work" at an outpatient orthopedic clinic and live with my classmate's parents. It's going well so far. Tomorrow I have three initial evals so I can start building my own caseload! It's exciting but a bit scary. The PTs that I am working with are good. They answer questions and also challenge me. I think I will improve a lot on evaluating patients and providing them with appropriate treatments--which is obviously huge in PT. The clinic gets a variety in patient population, but I have seen quite a few patients with neck/back pain, shoulder pain, or post-op following a knee or foot/ankle surgery. This clinic gets more post surgical patients than my previous clinic, so I am learning a lot as far as precautions go following surgery. This is also my first experience with half-hour treatment times. Half hours are pretty standard in the orthopedic world, but I have been spoiled with having an hour to work with patients. The clinic is private practice (like the one in Two Harbors), so I have already had some more experience with marketing and meeting with doctors. It's interesting, but I usually stay pretty quiet during those meetings.

So now I need to go re-educate myself on low back pain to prepare for tomorrow. Hopefully this post will be the beginning of re-semi-updating.

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.