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  • We're Not Going to Pay for That Brace

    A few weeks ago, a woman was admitted to our facility with a knee injury. She appeared to have ligamentous damage on top of arthritic deformities. She came to us for medical management and antibiotics prior to surgery. Before she was admitted, her orthopedist ordered a KAFO for the involved leg. I'm not a big believer in KAFOs. In my experience ...
    Posted to Toni Talks about PT Today (Weblog) on July 15, 2014
  • What's the Purpose of a PM & R Doctor?

    Until recently, I had never worked closely with PM & R (physical medicine & rehabilitation) physicians. When I worked at the ''evil empire,'' I dealt exclusively with neurologists. Some were good. Some weren't so good. Either way, their purpose for being involved in the patient's care was clear. There was a PM & R service. From what I ...
    Posted to Toni Talks about PT Today (Weblog) on September 10, 2013
  • ‘I Can't Wait Until I Can Walk Again'

    Last Saturday, one of my patients at the SNF was a woman with left femoral neck and humeral shaft fractures. She'd undergone an ORIF to repair the hip and the arm was immobilized. She was NWB on both extremities. Like many of our patients, this was not a small woman. She was limited by bilateral knee arthritis and admitted she didn't walk much ...
    Posted to Toni Talks about PT Today (Weblog) on August 20, 2013
  • Sometimes Even the Doctor is Wrong

    I had a good laugh this morning. A doctor was ranting and raving that an order he'd written two weeks ago still hadn't been followed. The order was for a pressure-relieving shoe for a patient with a plantar wound. The doctor was very upset. He was making threats. He demanded something be done by 7 p.m. this evening or he would do something. The ...
    Posted to Toni Talks about PT Today (Weblog) on August 6, 2013
  • The Dangers of Stopping Warfarin

    Over the last few weeks, the stroke service has had a run of patients who have had strokes after stopping warfarin therapy. The reason was usually to have an outpatient surgical procedure. Because warfarin thins the blood the surgeons have the patient stop the therapy a few days prior to the procedure. They resume the drug once the risk of ...
    Posted to Toni Talks about PT Today (Weblog) on July 12, 2011
  • Early Mobilization

    In last week's issue of ADVANCE for Physical Therapy& Rehab Medicine, the cover story described a three-month clinical trial of early mobilization in the ICU. I wanted to cut it out and post it prominently at work. I think all medically stable ICU patients should be mobilized, and I mean out of bed. Author Lisa West points out there is ...
    Posted to Toni Talks about PT Today (Weblog) on June 7, 2011