Daniel's Senior Blog: February 2014

Wednesday, February 26, 2014

Blog 16: Advisory Meeting #2

My answer 2 would be "The path to treating a torn ACL is to follow the protocol and exercises set by the physical therapist.

1.One reason would be strengthening the leg so that a person can return to sports and be able to function normally
2. Following protocol will lower the chances of getting injured
3. To learn your limits as to have better understanding of what not to do in the future.

My Physical Therapist and mentor Georgine is my source

Tuesday, February 11, 2014

Blog 15: Independent Component 2 Approval

1. What I plan to do for the independent 2 component is to get to a stage where I can comfortably use my leg and get to a level where I can run. I will continue my work at kaiser Permanente.

2. I will continue working with my physical therapist for my thirty hours. I will also research methods used by different therapists.

3. The proof of my progress will be shown from the progress of my own leg. I am continuously getting new exercises and I am improving in the amount of weight I can put on my injured knee. I will also know many treatments and exercises that help improve leg strength and durability.

Thursday, February 6, 2014

Blog 14: Independent Component 1

A) I Daniel Song, affirm that I completed my independent component which represents 30 hours of work
B) My main sources were my P.T Georgine Hernandez and Dr. Meletus my surgeon. Dr. Meletus explained to me the process of my surgery and what I should expect and do after the surgery. Georgine has helped me with the condition of my knee. She explained to me the purpose of the exercises that I do and tells me to go to my limit.
C)
D) Basically for my independent component I experienced the healing process after an ACL operation. It is much different from reading about it. I learned that after surgery your whole leg loses a lot of its original muscle mass. Rebuilding the muscle is very difficult especially with a reconstructed knee. However before actually working the knee you have to strengthen the areas around the knee like the gluteus, hamstring and the back. I learned the amount of time which it takes to get off the brace which standardly would be after a 3 weeks to a month. Actually experiencing post op healing process helped me know that the main goal is to reduce the swelling and to bring some flexibility of the knee back.

Interpretive

The progress of my knee supports my component. In the beginning after surgery I wasn't able to bend my knee but now I can go 125 degrees. I'm able to walk without support and I have a better understanding and knowledge about ACL tears

Applied

The independent component really helped me with understanding the basis of my senior project. Actually experiencing what I had read made me understand better what exactly I was reading. I experienced the post op healing process and the exercises that ACL tear patients have to do. Also because I am surround by professionals I received information that I didn't know before such as the most dangerous period of healing is from weeks 6-12 and the reasons for certain exercises

Mentorship Log

Date	Hours	What i did	Total Hours
7/19/2013	8	On the first day of mentorship i was given an orientation of the physical therapy area. They allowed me to watch the work they did and handed them whatever that they needed.	8
7/26/2013	4	On the second day of therapy I did all sorts of work. With the help of one of the P.Ts i cleaned the ice machines. After i watched some of the procedures and helped with whatever I could.	12
8/2/2013	4	Third of mentorship I helped the P.Ts with some of the patients. I helped a patient to her car and handed ice pack and set / cleaned beds.	16
8/9/2013	4	Fourth day of mentorship I have new fellow interns. We split the work into thirds, but there is more than enough work so we are all kept busy. Today we all helped with the P.Ts work and also made some copies of folders for a presentation.	20
8/16/2013	3	On the fifth day of presentation we helped the P.Ts with their patients and this time we saw a presentation given to patients with back problems. It explained the importance of the back and certain exercises that can be done throughout the day that can be done to help your back.	23
9/3/2013	2	I made copies of different exercises on little cards given to patients, I watched as the therapists conducted their therapies	25
9/5/2013	2	I refilled the hot water machines which are for heat packs and took out the ice pack machine and let it melt out. Doing this once in a while is necessary so that the ice doesn't build over itself and make it hard to put and take out icepacks.	27
9/6/2013	4	I stocked up booklets that the P.T's give when they have seminars or need to pass on basic info. I cleaned the gym area and also put the leg weights in order	31
9/9/2013	3	The P.T shares the department with the O.T occasionaly when O.T needs help	34
9/12/2013	1.5	There are personal areas for the P.Ts to do one on one therapies, and there is a gym where many patients come at once. I asked and the the personal therapies are more specialized injuries, but the gym patients are there for rehabilitation from different surgeries, treatments, or just working on strengthening.	35.5
9/23/2013	2	I spent most of the time in the gym and watching the Physical Therapists do their work. I have noticed that after a bit of time P.Ts do little evaluations on their patients to check their progress. If they are not at the level they should be the P.T tends to work them harder during the therapy session.	37.5
9/24/2013	2	I spent my time creating folders for seminars. This time there were several different types. There were a total of three types of folders I had to make which were the neck, knee, and back. Each of the folders contain basic information about these body parts and exercises done to prevet such injuries.	39.5
9/26/2013	1.5	I cut up therabands into equal sized pieces. Therabands are used by P.Ts for many exercises, but I mainly see the therabands used for leg exercises. They are used for resistance training which is basically like strengthening.	41
9/27/2013	2	I have noticed that all the therapists have different ways of therapy. The way they approach a patient is different, some are very friendly which eases the patient and others are rather straight to the point which reassures the patient.	43
11/19/2013	2.5	I spent time in the gym cleaning up after the patients. I see that while patients are doing their exercises, the P.T's are careflly watching the movements in which they do their exercises. If something is wrong they tell their patient what they are doing wrong and help them fix it. I asked why it form is so important, and they said that without proper form a patiet could be working out muscles that are not intended or patients could put unecessary strain on their muscles/joints.	45.5
11/21/2013	1	I cut up the therabands and took out the ice machines. After letting the ice melt you have to let the water drain out and wipe the leftover water from the machine.	46
12/5/2013	1	I made photcopies of exercies for a P.T. The photocopier continuosly broke down so I had to check and fix the jams in the copier.	47
12/11/2013	1	Watching patients in the gym, I have noticed that each patient progresses differently. Some patients that start earlier actually progress quicker than those that started earlier.	48
3/7/2014	2	I cleaned out the personal offices of the P.Ts . The P.T's offices tend to look more like examination rooms. Unlike doctors who conduct procedures in other rooms, P.T's do it all in one. Each of the offices have many supplies and shows that the P.Ts are always ready.	50
3/13/2014	1.5	I helped around the P.T gym, cleaning after patients. Typically this work involves changing pillowcases of used pillows, putting back icepacks into the ice machine, providing ice packs or whatever patients need or restocking on different supplies.	51.5
4/18/2014	2.5	I cleaned the machines around the gym	54
4/25/2014	1	I helped around the P.T gym, the P.Ts asked me to photocopy a book about therapy	55
5/5/2014	2	I helped around the department. I cleaned up things leftover by the patients, and organized some of the equipment that were tossed around the gym area. I also cleaned up some toys that were in the O.T department.	57
5/7/2014	2	Today there were observers from a school who took a tour with the P.T's. They helped out with the workload and did thing that the P.T told them to. They helped me with photocoying a thick book. I also refilled the hot water in the hot packet machine and I also cleaned and disinfected the P.T's personal rooms.	59
5/9/2014	1	I organized the different equipments around the gym. So if something is not in the place it should be I put it back, things like leg weights, bosu balls, cones, etc. I also cleaned the gym equipment	60

Independent Component 2

Date	Hours	What I Did	Total Hours
2/7/2014	2	I went to P.T and learned some exerices that people do before even deciding to go through surgery	2
2/12/2014	2	I went to P.T and got some new exercises	4
2/14/2014	2	I went to P.T today and did exercises I also saw procedures that the P.T did	6
2/19/2014	2	I went to P.T and did my exercises	8
2/21/2014	2	I went to the doctor and he did a test my knee	10
2/26/2014	2	I went to the doctor and he did a test my knee	12
2/28/2014	2	I went to P.T and did my exercises	14
3/5/2014	2	I have started running during P.T along a few extra exercises for my P.T	16
3/7/2014	2	I did received new exercises	18
3/12/2014	2	I went to P.T and did my exercises	20
3/14/2014	2	I went to P.T and did my exercises	22
3/19/2014	2	I went to P.T and did exercises	24
3/21/2014	2	Iwent to an appointment and talked to Dr. Meletus and he told me that some people opt not get the surgery, but if their knee is not strong enough it can lead to future complications	26
3/26/2014	2	I went to P.T and did exercises	28
3/28/2014	2	I saw new patients come in today with different procedures done and saw that the P.T did different things with them.	30
4/2/2014	2	Today I talked with another P.T and she said that some people choose not to get surgery if their legs feel fine after a couple weeks of physical therapy.	32
4/4/2014	2	I did new exercises today with squatting with a ball.	34
4/7/2014	1	I volunteered today and saw P.T's working with ACL patients and how they checked the strength of the leg	35
4/9/2011	1	I volunteered today and helped the P.Ts with different things	36

3 Column Chart

	2	Name:Daniel Song		House: North		Topic: Physical Therapist

Three Column Logic Chart


	Statements		Reasons		Verification (Source #, Author/Title)
Topic		Physical Therapy		Given		Given
Foundation	a)	Physical Therapy:the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.	a)		a)	Source #1 Physical Therapy
	b)	ACL:The anterior cruciate ligament is one of the 4 major ligaments in the knee and holds together the tibia and the femur	b)	The ACL is the main focus of the project	b)	Source #11 ACL Injuries: Treatment and Rehabilitation
	c)	Rehabilitation: The act of restoring something to its original state	c)	A major part of healing is due to rehab	c)	Source #22 The Five Physical Therpay Goals after ACL Reconstruction
	d)	Surgery:the treatment of injuries or disorders of the body by incision or manipulation, esp. with instruments.	d)	The first step to an effective healing process	d)	Source # 17 ACL Graft Choices
EQ		EQ: What is the most effective treatment process for a torn ACL		Given		Given
Answer 1	a)	Autograft surgery:is the bone of a patient for use in grafting procedures in their own body. Bone is taken from one part of the body and grafted onto another part of the body to replace damaged tissues.	a)	Using the autograft procedure allows for a more effective healing process because the doctor is using the tissue from your own body so the acceptance rate is 100% and is much more stable than using a cadaver.	a)	Source #19 Health Guide ACL Reconstruction
	b)	Dr. James Andrews is a famous Orthopaedic Doctor who has operated on many famous athletes.	b)	Dr. James Andrews is one of the top Orthopaedic Doctors operating on many famous atheltes and chooses to go with the autograft surgery	b)	Online Website
	c)	Higher succes rate when using autograft vs. allograft.	c)	The autograft is what most doctors use for ACL reconstruction surgery. It has a higher success rate due to using the persons own body tissue. The Allograft uses a cadaver which is less stable and has side effects.	c)	Source #18 Graft Choices in ACL Surgery
	d)	Answer 1: The first step to an effective treatment process is to have an autograft surgery.	d)	(Explain why this answers the EQ) The first step to an effective treatment starts with reconstructing the ACL which is the foundation. Without a good foundation, the knee will have future complications.	d)
Answer 2	a)	blood platelets	a)	Greatly increases the speed of healing in the knee	a)	Source#49 ACL Alternatives and Options
	b)	non-surgical	b)	There is less strain on the patient and the knee	b)	Source# 49 ACL Alternatives and Options
	c)	no rehab	c)	There are less future complications because there is no excessive strain on the knee.	c)	Source#50 ACL Procedure Outcome
	d)	Answer 2: The best non-surgical treatment for a torn ACL is to have a stem-cell treatment	d)	(Explain why this answers the EQ) The treatment process completely heals the ACL without opening up the knee. There is no need for rehab which may be more convenient for the patients.	d)
Answer 3	a)	no surgery	a)	No risk of future complications	a)	Source# 51 Torn ACL may heal without surgery
	b)	Rehabilitation	b)	Assesses the patients need for ACL Surgery	b)	Source#16 ACL Injury:Does it need Surgery
	c)	stability	c)	If there is enough stablility in the knee after rehab patient can opt to not have surgery.	c)	Source#16 ACL Injury:Does it need Surgery
	d)	Answer 3: An effective treatment may be one with knee rehab	d)	(Explain why this answers the EQ) A treatment which shows people whether or not they need ACL surgery. If a person does not need the surgery then it frees them from any future complications with the knee.	d)
Best Answer	If: If my 3 answers are autograft surgery, stem cell treatment, and knee rehab
	Then: Then my best answer would be ACL surgery
	Because: According to the US National Library of Medicine The allograft group had a failure rate 15 times greater than that in the autograft group, with all failures occurring within the first year after reconstruction, with the Autograft group having little to no complications.