Sports medicine is starting to make me ill

We have been so busy at Wildwood this week that I feel like my brain is going to explode. Yesterday we saw 21 patients plus 3 new evals and I had the worst headache imaginable. On the plus side, the day went by super fast, because I barely had time to even glance at the clock. It was hectic.

Despite the fact that I'm really enjoying the outpatient setting, I am starting to realize that maybe sports medicine just isn't for me. I do like working with athletes and learning how to treat various types of sports injuries. However, I only like working with athletes who are over the age of 20. Teenage athletes are pretty much getting on my nerves to put it bluntly and their parents are getting on my nerves even more. I know that this is my specialty clinical and the reason I got my CSCS is because I really wanted to work with athletes, but I will give you just a few examples of why I am starting to change my mind about what I really want to specialize in.

• Athletes (the teenage ones) all come in with their cell phones and iPods. Now, I am not one to ever knock the use of cell phones and iPods. I have both and I use them regularly. I don't know what I would do without texting. However, teenage athletes 99% of the time feel the need to be texting throughout their therapy sessions and/or listening to their iPods so they are NEVER paying attention to what you ask them to do and you always have to either a) wait till they are done sending a text or b) shout out your instructions to get them to listen.
• Teenage athletes never want to use the correct form with exercises. They all think that faster is better and they are all just trying to get through their "workout" as fast as possible. They don't seem to grasp the fact that they are there for physical therapy, not a practice session.
• The parents of teenage athletes can be super pushy and rude. Case in point - we are seeing a 14 year old kid with Little League Shoulder. This is when the epiphysis separates in the throwing shoulder. It is a very serious injury and getting back to pitching too soon can cause serious damage. The problem here is, this kid is an outstanding pitcher. He has the potential to go pro someday and he and his mother know that. They are not at all interested in actually going through the appropriate progression of therapy. They also do not understand why we are working on core strengthening with him. I guess they do not understand that your arms are attached to your trunk and it's the entire upper body that's involved in throwing a ball, not just your arm. But whatever...So the past 2 times I've called this kid in from the waiting room, his mom has come back to the gym with him. The first time, she got on my CI's case about the core strengthening and basically told him that he should just work on her son's arm and forget the rest. The 2nd time (yesterday) I called the kid back and she came charging in behind him and told me basically that she didn't want me to see her son because they had waited all week to get an appointment with my CI. She wanted my CI to do an "assessment" for her son to see if he was ready to get back to pitching. Um ok....so that made me mad that she thought I was too much of an idiot to treat her son and it also made me want to shake the crap out of her and tell her that there is no way in heck that her son is ready to pitch again. So I get my CI and I just go start seeing our other patients. I see he is speaking to this woman and her son for a long time and getting frustrated. I hear the mom basically say how frustrated she and her son are that "PT isn't working." It's safe to say that I never ever want to work with parents like that who want to destroy their kid's potential pro career by pushing them too hard as a freshman in high school. You've got to be kidding me.
• Athletes whine and have the lowest pain tolerance imaginable. We have adults who've been through total joint replacements who work harder than an athlete with a sprained ankle. It's annoying.
• They are always late for their appointments or just plain don't show up. Our highest rates of No Shows are the athletes.
• There are only about a handful who actually are compliant with their home exercise program and it is very obvious.
• They are so disrespectful toward their parents. I evaluated two athletes this week who were completely rude and disrespectful toward their parents throughout the entire evaluation. They talk back, act like little snots, and one kid threw his sweatshirt at his mom and hit her in the face when I asked him to take it off so I could see his shoulder.

These are just a few of the reasons why I'm starting to question my choice to get into sports medicine. Don't get me wrong, I really do like it, but I find myself gravitating toward the patients who are older and more mature every single time we are double booked and I'm starting to get the hint from myself that maybe athletes just aren't my cup of tea.

T-minus 11 days

Oh how I wish I could just stay up late every night and watch the olympics for 2 weeks straight. Gone are those days...I just have to settle for the 2-3 hours that I may or may not be able to soak in at the end of the day.

Today I was reminded of just how glad I am that I am done with PT classes forever. During the 2nd year of PT school (which would have been last year for me), all students are required to take an elective. I obviously took the CSCS elective (and passed the test!), but one of the options is a sports medicine elective where you get to learn about all different types of sports injuries and how to treat them. Today, my CI was the guest lecturer for that elective so the students from the 2nd year class that are taking that elective came to Wildwood this afternoon at 4:30 to listen to his lecture. My CI asked me if I would like to sit in on it and I gladly said yes, because that meant I could give my mind a break for 2 hours and lay back and do a whole lot of nothing while he gave his 2 hour lecture. Well, wouldn't you know that he decided to give the lecture in a dark room where I just wanted to fall asleep and then ended up going over by a half hour, so we didn't even get to leave until 7pm. Let me just say that working 7:30am (leaving my house at 6:30am) and not getting home until almost 8pm is a LONG day...I guess I was meant to sit through that lecture just to be reminded of how glad I am that I am done with classes forever.

Speaking of stress, although we were done with patients at 4:30 today, it was probably one of the more hectic days on the schedule so far, especially since my CI is starting to have me be pretty much independent with the entire caseload. This means approximately 4 evals/day (each including about 10+ pages of paperwork...ugh) and approximately 18 other patients on top of that. If it weren't for the amazing people I work with, I would never make it through. I think some of the rehab aides are the only reason I keep my sanity.

All in all, I can still say that I'm glad I'm having this experience. I am getting my butt kicked daily. Some of the benefits of this are:

- I have more appreciation for any future job that I have in which I am only scheduled to see one patient at a time.

- Working 8-4:30 will seem like a vacation.

- I am finding the motivation to study for boards, based solely on the fact that this clinical has made me realize all of the information that I have yet to learn.

- If I ever become a clinical instructor in the future, I will have more understanding and compassion of what my students are going through.

- I am learning more on this clinical than I ever did in 3 years of PT school.

- I have made good friends at this clinical, and with any luck, will be able to keep in touch with them after the clinical is over.

- If I am so lucky to be offered a job within a 30 minute (or less) driving distance from home, I will take it in a heartbeat.

I love Wildwood, the people that work there, and the patients...but I am a) too tired to drive there any more days that I have to and b) not a big fan of the whole 2-3 (or sometimes 4) patients at a time scheduling so that half the time our patients aren't receiving the quality of care that they deserve...

11 more working days, one inservice presentation, and one service project until spring break and then Montpelier!

Ready, Set, Weekend!

Another weekend to relax...I am enjoying it :) As much as I have complained about my clinical, I do have to say that it is going by faster than any other clinical ever has. This is probably because 1) it's a sports medicine / orthopedic clinical which is exactly what I want to specialize in someday 2) I work four 10 hour days, so the one day off during the week makes the weeks seem shorter and 3) because it's wintertime and there's nothing better to do anyway!

I'm slowly but surely getting more and more confident in my ability to independently evaluate and treat such complex patients. Some of them are not so complex...for example, I'm pretty much an expert (slight sarcasm, but not much) when it comes to treating people for neck/back pain and I'm getting pretty good with shoulders and knees. Monday, I am evaluating a patient for a talus fracture. Week 1, I would have been totally intimidated and freaked out by this, because I'm sorry, but how in the heck do you fracture your talus? It is the "dumbest bone in the body" according to Gary Gray. Well...I'm currently excited about doing this evaluation and a) find out how this happened and b) see if I can successfully treat it.

I'm pretty proud of myself because I evaluated a patient about a week and half ago and successfully diagnosed her with a frozen shoulder (a/k/a adhesive capsulitis). This should be a pretty easy diagnosis, but it's the first time I've ever been able to diagnose a patient all on my own. Needless to say, I was pretty proud of myself. Not only have I diagnosed her, but I have been doing her treatments based on my very own treatment plan and it has worked. She is getting a lot better. It's very encouraging! Ok, yeah I've seen a lot of patients that I developed my own treatment plan for and they got better, but this is the first one that I actually diagnosed as something different than what her primary physician diagnosed her with (rotator cuff tendonitis) and treated. The fact that she's getting better with MY plan makes me feel like I might actually be smarter than I've given myself credit for.

I am also giving my CI my full respect again, even though I thought it was pretty insensitive to make me go in on Wednesday, because I can tell that he felt bad about it after the fact. Yesterday was a very good day. I decided that the best route is to be completely professional so I told him that I really wanted to make up for the day that I missed in some way, even if he didn't want me to come in over spring break, I would at least do an extra project or homework assignment. He said that he would give me just one more homework assignment to work on, because I have already done so many. I think that's pretty fair. So that's how I'm making up for my snow day. I really can't complain. Plus, I am going to luck out on Monday because we're apparently done with patients by 4pm so he can give a presentation to the 2nd year DPT students in the sports medicine elective, so I get to sit in during his presentation for the last 2 and a half hours of the work day. The best part is, they are making the students come to our facility, so I don't even have to drive to the school for this. Score.

In other news, I'm pretty excited that the olympics have started. My TV is pretty much glued to NBC for the next 2 weeks. I've also been inspired to start working out again seriously. I've been such a lazy bum. I finally bought my own physioball at Walmart today and pretty much killed my abs on it and I'm going to get back to biking until the snow melts and I can go outside and run again. I think I can handle the schedule of full-time work, studying for boards, and working out like a beast. But we'll see. The overall number one goal is to pass the boards. Then get in shape enough to look like a respectable physical therapist. Wish me luck.

Ignorance has got to be Bliss

I am so furious and I don't know if I will even get over it in the next 3 weeks. I am trying very hard to be "professional" but it's been pretty difficult to bite my tongue.

As I said in my last post, I called in to my clinical on Tuesday due to the snow storm that we got. Whenever we miss a day of our clinical, we are supposed to email our clinical coordinator at school and let her know. So, I thought I was doing the right thing and emailed her and let her know that I missed Tuesday due to the bad road conditions and that I did not feel safe enough to be on the road. Tuesday night, I received an email back from her basically saying that she understands my decision not to go in, but I need to formulate a plan with my CI to make up for my absence so that it doesn't seem "unprofessional" and that "now that the roads are cleared off" I should head to Toledo and stay with "someone" so that I can make it to my clinical the next day. Um....ok.....

So I replied back that we were currently under a level 2 snow emergency, as was Lucas county, and that I was not trying to be unprofessional in any way. I apologized for my absence, but tried to explain that I can not afford to total my car and have injuries/hospital bills right before graduation when I am going to have student loans to pay off and will NEED to be working as a physical therapist (pretty difficult to do if you're injured). I gave her plenty of notice that I would probably be missing yesterday (Wednesday) as well since the conditions had worsened.

Yesterday morning, I woke up at my normal time (ugh...5:30) and looked outside and saw that my car was completely stuck in a snowpile. I watched my neighbor out back trying to leave for work at 6:30 and get his car stuck in the snow-covered parking lot. I still got around for work like I normally would, but then saw on tv that there were all kinds of car accidents. As it got lighter, I saw that my car was definitely stuck. So I called in to my clinical site. The receptionist was very nice and said that was fine. She asked if I wanted to speak to my CI and I said yes so that I could get an idea of how he wanted me to make up the missed hours (whether it be making them up over spring break or coming in on a couple of Thursdays, etc.). He gets on the phone and I tell him that I am very sorry but I will not be able to make it in. He says, "At all?!?!" and I said, "well unless the conditions improve, I might be able to make it in this afternoon. My car is currently stuck." and he says, "well go out, get your car unstuck and GET HERE. The roads are fine once you get out of your area."

Ok...jerk. I was so mad, I about started to scream at him. But I just said ok...went out and spent 30 minutes getting my car out and headed toward Toledo. I had to drive 20 miles per hour the whole way there because the road was a sheet of ice that had been packed down by all of the snow plows. Every time a semi went by in the other direction, it sprayed so much snow that I could not even see where I was going. It was impossible to see the lines on the road to even know if you were ON the road, and if any of those semis going the other direction had jack-knifed, I would have been dead. Thanks Wildwood for making me risk my life to get to your stupid clinic. Of course, once I got to Toledo the roads were fine and completely clear because more traffic (that had been going slower and stopped for stop lights) had been on them to warm them up. They had also been salted.

I get to the clinic at 9:30 and the receptionist who had taken my phone call got a very surprised look on her face and said something about how my drive was. I was so shaken up by the drive that I had tears in my eyes. I told her it was horrible and walked back to the gym. I get to the gym and one of the ATCs asked me how my drive was (in front of my CI) and I just said, "I don't want to talk about it." I looked around and saw that both PTA students at the clinic had called off and no one had made them come in. At lunch-time, my CI and his wife (who also works there) sat down at the lunch table and his wife says really loud and pronounced (apparently for me to hear), "the roads are FINE. They're all completely clear." I wanted to be like "Yeah in f-ing TOLEDO. They are not clear in RURAL areas if you would watch the f-ing news." but I kept my mouth shut. Then, one of the other employees of the clinic came in and said that she had tried to call off and they made her come in as well. She lives near me and came in furious that the rehab director had made her come in. She started explaining (in front of my CI and his wife) how horrible the roads were and how she felt like she had really risked her life to come in. I agreed with her and we sat there talking about the horrible road conditions for about 30 minutes, while my CI just stared at us.

I later went back to the office and my CI came in behind me. I told him how sorry I was for missing Tuesday and that I would be more than willing to make it up the Monday of spring break. He told me not to worry about it at all and it wasn't a big deal. He said, "we're pretty understanding of that here." What a joke. No you're not. You're not understanding at all. You think everyone who works there lives within a 5 block radius and that it was no trouble at all to get there. You have no respect for my life and the fear I felt driving to your stupid clinic. I have no respect for my CI anymore. None. I know we are supposed to have professional relationships and I will keep it that way. I didn't argue with him at all and when he told me I could leave yesterday at 6 instead of 6:30, I didn't even attempt to ask if he was sure that was ok. I just took off. It was already getting dark and I knew my drive home was going to suck just as bad as it did getting there. Several people told me on my way out to "be careful!" in front of my CI. I'm sure he doesn't feel bad in the least for making me come in yesterday, but I for one have no respect for his attitude about it.

I get home and have an email from my clinical coordinator that made me feel a little bit better. She told me that she didn't feel I was being unprofessional at all, just to be sure I spoke with my CI about making up the hours. Well, I did that...But she also said to get used to the fact that not all clinics are the same and "life isn't fair." Um yeah, I know life isn't fair, but let me just say one thing....I'm pretty glad I have a "life" and I'd like to keep it. You're not going to tell me that "life isn't fair" when it comes to risking it to get to a clinical.

The best part of this whole scenario, at least 5 of my classmates with clinicals in Toledo did not go in yesterday. They all called in, except for one who's clinic called her and told her that they were closed for the day due to bad weather. Her clinic is the St. V's outpatient department, located about 2 miles away from Wildwood.

Needless to say, the next 3 weeks can not go by fast enough.

Snow Day

Well, it looks like we're in for the "blizzard of 2010" or something along those sorts that channel 11 news will call this. We're expected to get 12+" of snow between today and tomorrow. I woke up this morning at 5am to a tiny bit of snow, watched the news and there were no cancellations, went to get around for work, came back to the tv and there were tons of cancellations. I look outside and just in that 45 minutes time, we had over 2 inches of snow on the ground. I went out to my car and started to leave, got 1 mile out of town, and turned around. I could barely see where I was going and the snow was drifting all over the road.

I ended up calling off of work and they acted pretty mean about it. I feel horrible. I know it's a clinical and I really should be there unless it is a level 3 snow emergency, but I really did not feel safe driving there today. I know that these conditions are only going to get worse and most of our patients will probably cancel their appointments anyway. I suppose it would be different if I was in an acute care setting for my clinical, but I'm not, and I would be so bitter if I risked my life to get to work and then all the patients canceled anyway.

Needless to say, however, I do feel pretty horrible for calling off. Now that it's getting light out, it doesn't look as bad as it did when it was dark this morning. But they keep saying how it's going to get a lot worse and I, for one, did not want to get stuck in Toledo. I also didn't want a totaled vehicle right before graduation. I guess I will just pay the price of getting lectured about it and probably having to make the day up later on. I am by far not a baby when it comes to driving in bad weather. I can drive in some pretty crappy conditions, but this I refuse to drive in. Everyone can call me a baby and lecture me for my "lack of work ethic" all they want, but I have been on time every single day and willing to stay late every single night. If I want to play it safe and stay home, I should be able to do that without any receptionists getting snotty with me for calling in. Oh well...guess I'll just sit here and feel guilty all day!

putting things into perspective..

Today I went with a group of people from my church to serve food at a homeless shelter in downtown Toledo. I'm not trying to brag about my community service efforts or anything, but I am really glad I went to do that this afternoon. It taught me a lot about being more appreciative of the things I have in life and the opportunities I have been given. It also taught me a lot about patience and compromise.

The particular shelter that we went to was a Christian-based shelter and therefore does not receive any money from the government and relies totally on the generosity of others, particularly from various church groups who donate their time and money to help. In order to stay at the shelter and receive meals, individuals are required to abide by a particular set of rules (no handguns, no violence, no swearing, etc.) and attend church services.

We were told to arrive at the shelter by 4pm to serve food, so we left here at 1:30 to give ourselves enough time to set up and get everything ready. When we arrived, we were told that the first meal service isn't until 5pm. Since we arrived at 2:30, we had over 2 hours to get everything ready. When we were just about done getting set up, we saw another group of people walk in with large containers of hot food. We realized soon that they were from another church and the shelter had accidentally double-booked two churches to bring food on one night. Since the other church was from Sylvania and we were from farther away, they graciously let us stay and serve the food that we had brought and said that they would reschedule their time. This was the lesson in patience and generosity. I can imagine they probably weren't the most thrilled to have prepared all of that food just to realize that we were already there with food to serve.

We didn't serve food to any women or children in person. They have a separate house that they stay in that we sent food over to. We served food to about 80 men in person. Many of them thanked us several times and even came up to us after they ate to thank us again. They were all very polite and many of them refused seconds, even though we had plenty of food, stating that they did not want to appear "greedy." The whole experience left me wondering how I would act if I were in their shoes. Would I have taken the time to come up after the meal to thank the people who had brought food? Would I have been able to hold back on the amount of food I ate in an effort to save more food for others, even if I was hungry and cold? I honestly don't know...I can only imagine how difficult that must be for them. Here I have been complaining on and on about how stressful my life is and how hard it is to go through PT school when there are people out there who don't even have a place to live and have to rely on groups like ours just to have enough food to survive. This experience really put things into perspective for me. I thank God for all of the opportunities He has given me and all of the blessings He has provided for me. I may not have a lot of extra money to give to others, but I will give what I can of my time and effort to help those in need.

Just keep swimming...

Ah my much-needed day off....things are getting crazier and crazier by the day at Wildwood. While I watch the other PT students seeing one patient while their CIs see other patients, I have somehow been given the responsibility of trying to juggle the entire caseload, meaning I am attempting to see 2-3 patients at a time all day long, while squeezing in last minute evaluations over my lunch break. These 11-12 hour days 4 days a week are starting to exhaust me. While I'm glad for so many learning opportunities, I think it's just a teeny tiny bit unfair to expect me to handle the entire caseload of a PT who's been working there for over 5 years and has traveled with the olympic team to treat athletes at the games. I mean, come on..yesterday during lunch we had to squeeze in an evaluation for a gymnast who fell on her head and was having sternum pain. Um...I can honestly say that I NEVER learned in school how to treat sternum pain. Seriously. So now I will probably fail the CPI (my midterm grades that I will be receiving tomorrow), because I had absolutely no clue where to even begin with this person. Tomorrow I'm evaluating a patient who has had achilles tendon repair. Do you think we've discussed that in school? of course not. So it's starting to get just a little overwhelming trying to evaluate these people and treat 2-3 other people at the same time and do it over and over again all day long.

To top it off, I haven't even started my service project or presentation that I am giving in a few weeks. My CI has given me homework on patello-femoral pain that involves me having to read 10 articles that are all about 10 pages long and then answering 15 questions on them by Monday. I still have to fill out my own CPI today, and trying to grade myself is really going to suck. To make it even better, something in the dry winter air this season has made the skin under my fingernails pull away from my fingernails, leaving me with bloody fingers where they crack and bleed, so all of my fingers are bandaged and I can hardly type or write. Awesome.

But...with that said, I am still trying to have a better attitude. I keep looking at all of this as a great learning experience and as much as it sucks, it will make me a better PT. If I ever get a job in a low-key setting, I will appreciate it 10x more than I would have before. Let's all keep our fingers crossed that I actually pass my CPI tomorrow and don't leave crying over the fact that my CI thinks I am at "beginner" level. I really don't want to have to email our clinical coordinator and explain to her why my CI thinks I'm a total idiot.