Last week in his post, fellow ADVANCE blogger Dean Metz shared some good news. CMS has ruled the need for skilled intervention, not functional improvement, makes therapy reimbursable. This means, as he pointed out, patients with chronic conditions can receive treatment without first experiencing an exacerbation. This will undoubtedly result in an ...

When I was at the horse show last weekend, I learned one of the show kid mothers is a PT. I learned this because she was treating another of the mothers using cranio-sacral therapy. I'm not sure what pushed more of my buttons, her treating someone on the fly or using cranio-sacral to do so. This isn't the first time I've said I don't think PTs ...

This morning there was a patient on the floor so the request went out for lifting help. Four people responded, including me, a PTA, a male CNA and the patient's nurse. The patient was a big man, weak and in a narrow space so it wasn't going to be easy. As we were positioning ourselves to lift him the nurse stepped away. She said she didn't lift ...

I believe I've mentioned being a certified McKenzie therapist in my former (pre-neuro) life. I still use those skills, particularly when one of my horses needs some work. However, I generally don't talk about it. I like to avoid those ''why aren't you doing that?'' questions. Nor do I want to spend my lunch time fixing someone's back or ...

Today was one of those days. There is a full moon. Healthcare workers often joke about the effects of the full moon on their patients. I believe there is something to that, which means my patients gets more of a workout than usual. I am used to brain-injured people being difficult, making inappropriate statements and being confused. I shrug it off ...

I don't like my job very much right now. It was never my dream job, just a means to an end. The biggest attraction to me was the ability to leave work in time to ride my horses and do it whenever I want. The patients and other therapists I work with are nice. I thought it would be enough. I was wrong. This is the first facility I've ever worked at ...

Sooner or later, everyone comes in contact with a patient who swings at her, attempts to bite or scratch or spits. It goes with the territory, especially if you work with patients who have brain injury or Alzheimer's disease. We console ourselves with the thought that the patient doesn't really mean to do it. It's simply a reaction to fear or ...

This week I found myself at an outpatient orthopedic clinic treating work-related injuries. The clinic was one of several in the area. They have agreements with many local industries to provide medical and therapy services to injured employees. The injured worker sees the doctor at the clinic, is given a script for therapy and starts as soon as ...

Once in a while I work with patients who have a diagnosis other than stroke. Two or three weeks ago, I evaluated a young man who'd had a TBI and was in the ICU. I later re-evaluated him following transfer to the rehab unit. Last week his rehab doctor noticed he had some ROM issues and decided to address them. Because I was the evaluating ...

This morning, one of the OTs I work with came in on crutches. She'd hurt her foot over the weekend and wasn't able to bear weight through it. She said she thought she would be OK because she could do most of her work sitting down. Occupational Health didn't agree with her. They sent her home. That is one of my biggest fears. I'm afraid I'll be ...