The only reason for this entry is to try to help motivate myself to read PT literature, absorb some of it, and maybe use it as a reference. Please ignore.
From Advance
Cardiac Rehab
1. Supervised cardiac classes 3 days a week working up to a goal of 50 minutes to an hour of cardiovascular exercise for about 12 weeks using UBE, elliptical, stationary and recumbant bikes, stairsteppers, and treadmill. For patients recovering from heart attacks, heart surgery, and minimimally invasive procedures like an angioplasty.. Benefits: With over 24 visits 19 percent less likely to die over 5 years. 3 phases of cardiac rehab: 1. Begin immediately throughout hospital stay. Focus on reducing blood clots, improving respiration, vital signs monitored. Done daily. 2. Outpatient medically supervised and education. Many are group setting, 3 days a week. Lasts a week to several months. 3. Long term maintenance program for life. Continue rehab at home or long-term cardiac rehab program.
Bariatrics
1. After bariatric surgery: resume dietary activites by surgeon's guidelines and exercise. Begin exercise routine as soon as possible. Early avoid straining surgical site to prevent hernia. Walking is usually first exercise. They should progress to 10,000 steps per day. Keep exercise log and determine calorie buring (good resource from Mayo clinic to determine this). Progress to gentle stretching and strengthening with very light resistance at first with higher repetitions progressing to from one to three times a week. Then progress to core strengthening and stabilization as cleared by surgeon and then mixed with cardiovascular exercise. Drink water peaking up to 64 oz a day. Keep the exercise interesting. Suggest they exercise with a friend or class.
Aquatic Therapy
1. Pool therapy can help reduce pain, increase range of motion, improve strength, control edema, improve functional activity tolerance and endurance. It uses hydrostatic pressure, which decreases swelling of the joints and improves joint position awareness. It decreases stress on joint especially for overweight patients and the risk of falling. The buoyancy provides a challenging environment for balance, propioceptive control and safety. They can stretch better without guarding. The warm water can assist in relaxing muscles and vasodialating vessels for healing, stimulating body awarenss, balance and trunk stability. Helps strengthen using water's viscosity for resistance.
Pharmacology
1. 2002 Beers Criteria for Potentially Inappropriate Medication use in Older Adults
1. Diagnosis: Arrhythmias. Drugs: tricyclic anti-depressants. Side effects: can result in QT interval changes. 2. Dx: COPD. Drugs: B-blockets, long-acting benzodiazepine. SE: may result in exacerbation or result in resperiatory deptression. 3. Cognitive impairment. Drugs: anti-cholinergics, barbiturates, central nervous system stimulants, muscle relaxants. SE: can produce central nervous system altering effects. 4. Chronic constipation. Drugs: anti-cholinergics, calcium channel blocers, tricyclic anti-depressants. SE: may increase constipation. 5. Depression. Drugs: prolonged use of benzodiazepine, sympatholytic agents. SE: may increase the depression. 6. Falls. Drugs: short and intermediate acting benzodiazepine, tricyclic antidepressants. SE: may result in additional falls, ataxia, and syncope. 7. Heart failure. Drugs: Disopyramide, high-sodium content drugs. SE: may result in negative inotropic effect. 8. Hypertension. Drugs: amphetamines. SE: sympathomimetic activity may increase blood pressure 9. Insomnia. Drugs: Amphetamines, decongestants, MAOIs. SE: can produce central nervous system stimulant effects. 10. Parkinson's disease. Drugs: conventional antipsychotics, metoclopramide. SE: can produce anti-cholinergic effects
Neurology
1. Foot Drop. Usually from nerve injury but can be from muscle or nerve disorder and brain and spinal cord disorder. Usually one foot. Commonly from stroke, Parkinsons, diabetes, motor-neuron disease, MS, drugs or alcohol, LE injury, low back condtion taht adversely affects the peroneal nerve such as vertebral fracture from osteoporosis, herniated disc, spinal stenosis, spondylolisthesis, bone fractures, or lacerations. Patients with foot drop from injury can expect partial or full recover. Neurologically it can be lifelong. Peroneal nerve control foot dorsiflexion. hip adduction and extended kneeling can apply pressure to nerve to increase risk of foot drop. Symptoms: high steppage, weakened leg muscles (ant. tib. EHL, EDL), hip swing, floppy foot, difficulty with actions of front foot, slight tingling or numbness, dragging front part of food while walking. Treatment: AFO, strengthening LE, stretching, gait training, estim to peroneal nerve, fusion or tendon transfer for long term foot drop, in the home: clear clutter, no throw rugs, electrical cords away from walkways, good lighting, flourescent tape on top and bottowm steps of stairways.
Ortho
1. Taping vs. Bracing. Tape: good for short term economically, customization. Bracing: good for long term use economically, long events where PT isn't available (i.e. hiking) to tape, in hot and humid environments
Orthotics and Prosthetics
1. AFOs. Metal-upright AFO: fluctuating edema, heat sensitivity, or prior satifaction. Plastic more prevalent. Lesser involvement: posterior-leaf-spring or pre-fab AFO; more involvement: more control and ability to adjust
Snow in Eldo
We heard the weather would be somewhat warmer in Boulder, so we decided to use our Colorado ability to do a multi-pitch rock climb and ski in the same weekend. This Saturday we chose to visit a new area for us in Eldo at Long John Wall. We pulled into a parking lot covered in snow and hiked past frozen streams, but once we began our sun shiny ascent, I was peeling off the jacket.
A couple oranges atop Long John Wall. It was fun to have a great view of a lot of routes we'd climbed across the valley.
Thankfully, there were no epics for us! Just good, clean mossy green shoots and cracks.
We returned home for the evening to celebrate carnivale with Brazilian samba music, dance, and some of my fellow capoeristas did a demonstration. It really, REALLY made me want to go back to Salvador.
On Sunday, we skidded our way down Keystone's icy slopes. I'm ready for some good snow already! Portland still wins for best powder of the season.
Traipsing around Hoosier Pass
I was so happy I was able to join my good friend Becky again this year as she was forced to attend medical meetings a few hours a day and then ski, ski, ski. Tough. Darren was already in the mountains, so I literally inched my way over to Copper in a snow storm. Somehow I got right behind a snow plow, and honestly I was glad I had an excuse to be in second and third gear on my way down Hoosier Pass. Thankfully I survived and was able to return the next morning to the top of my nemesis with Becky, Jesse, Kira, and Darren. Darren skinned while the rest of us slow-shoed our way to the top whatever mountain we were on at the pass.
Fresh tracks
Gatorade break!
We like each other...a lot.
The next day I was reminded why Copper is my favorite ski resort ever, while Darren backcountry skied his way down Quandary Peak (the mountain on the right side of the picture above). Besides all the snow fun, once again we enjoyed good food, good games, and good company with Becky and her family.
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